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<h1 itemprop="headline">Disability Benefit Coverage and Program Interactions in the Working-Age Population</h1>
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<div id="hByline">by <span itemprop="author">Kalman Rupp, Paul S. Davies, and Alexander Strand</span><br>Social Security Bulletin, <abbr title="Volume">Vol.</abbr> 68, <abbr title="Number">No.</abbr> 1, 2008 (released August 2008)</div>
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<p id="synopsis" itemprop="description">It is widely known that about three-fourths of the working-age population is insured for Disability Insurance (<abbr class="spell">DI</abbr>), but the substantial role played by the Supplemental Security Income (<abbr class="spell">SSI</abbr>) program in providing disability benefit coverage is not well understood. Using data from the 1996 panel of the Survey of Income and Program Participation (<abbr>SIPP</abbr>) we find that over one-third (36 percent) of the working-age population is covered by <abbr class="spell">SSI</abbr> in the event of a severe disability. Three important implications follow: (1) <abbr class="spell">SSI</abbr> increases the overall coverage of the working-age population; (2) <abbr class="spell">SSI</abbr> enhances the bundle of cash benefits available to disabled individuals; and (3) interactions with other public programs—most notably the <abbr class="spell">SSI</abbr> path to Medicaid coverage—also enhance the safety net. Ignoring these implications could lead to inaccurate inferences in analytic studies.</p>
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<hr />
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<div class="eightypercent">
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<p>The authors are with the Division of Policy Evaluation, Office of Research, Evaluation, and Statistics, Office of Retirement and Disability Policy, Social Security Administration.</p>
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<p><i>Acknowledgments</i>: This article is dedicated to Charlie Scott for his pioneering role in research and database development on the interactions of the <abbr class="spell">DI</abbr> and <abbr class="spell">SSI</abbr> disability programs. For useful comments and suggestions on earlier versions, the authors are indebted to Richard Balkus, Ben Bridges, Irena Dushi, Howard Iams, Linda Maxfield, John Phillips, Bob Weathers, and Susan Wilschke. We also acknowledge useful review comments received from <abbr class="spell">SSA</abbr>'s former Office of Disability and Income Security Programs and Office of Legislative and Congressional Affairs. Any remaining errors are ours. The article reflects the authors' technical analysis and assessment; the opinions expressed do not reflect official positions of the Social Security Administration.</p>
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<p>Contents of this publication are <a href="/policy/accessibility.html">not copyrighted</a>; any items may be reprinted, but citation of the <i>Social Security Bulletin</i> as the source is requested. The findings and conclusions presented in the <i>Bulletin</i> are those of the authors and do not necessarily represent the views of the Social Security Administration.</p>
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</div>
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<h2>Summary</h2>
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<p>Over three-fourths of the working-age population in the United States is insured for Disability Insurance (<abbr class="spell">DI</abbr>); this group is protected against a total loss of earned income typically associated with severe disability. However, little is known about the role the Supplemental Security Income (<abbr class="spell">SSI</abbr>) program plays in protecting against the financial consequences of severe disability for this population. We find that over one-third (36 percent) of the working-age population is covered by <abbr class="spell">SSI</abbr> in the event of a severe disability. Three important implications follow, which we discuss in sequence below: (1) <abbr class="spell">SSI</abbr> increases the overall coverage of the working-age population; (2) <abbr class="spell">SSI</abbr> enhances the bundle of cash benefits available to disabled individuals; and (3) interactions with other programs also enhance the safety net, most notably in the area of health insurance coverage. Ignoring these implications could lead to inaccurate inferences about disability program coverage, health insurance coverage, and the well-being of working-age individuals with disabilities.</p>
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<p>The first major finding is that <abbr class="spell">SSI</abbr> substantially increases overall cash benefit coverage. Thus <abbr class="spell">SSI</abbr> dramatically increases protection against the financial risk of disablement in the working-age population. While roughly 23 percent of the <abbr>U.S.</abbr> working-age population was not insured for <abbr class="spell">DI</abbr> in November 1996, <abbr class="spell">SSI</abbr> provides coverage for more than half of this seemingly "uncovered" population. An important innovation of our analysis is that we account for the possibility that many of those who appear ineligible for <abbr class="spell">SSI</abbr> based on current income could become eligible as a result of a disability shock that causes their earnings to drop. Thus the estimated proportion that is protected by <abbr class="spell">SSI</abbr> increases when the possibility of earnings loss because of disability is considered.</p>
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<p>Considering <abbr class="spell">DI</abbr> and <abbr class="spell">SSI</abbr> together, roughly 90 percent of the working-age population would be potentially covered for benefits in the event of a disability. Those who are covered by <abbr class="spell">SSI</abbr>—as opposed to those covered by <abbr class="spell">DI</abbr> alone—tend to be relatively young, less educated, and in relatively poor health. The remaining 10 percent or so are not covered by either <abbr class="spell">DI</abbr> or <abbr class="spell">SSI</abbr>. This group is economically vulnerable in some sense (they are poorer, older, and more likely to be women than those covered only by <abbr class="spell">DI</abbr>), but they are not as economically vulnerable in terms of income, resource holdings, and private health insurance coverage as those who are eligible for <abbr class="spell">SSI</abbr>. A disproportionate share of those who are not covered by either <abbr class="spell">DI</abbr> or <abbr class="spell">SSI</abbr> consists of married women.</p>
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<p>The second major finding is that <abbr class="spell">SSI</abbr> substantially enhances the bundle of available cash benefits. Roughly one-third of those covered by <abbr class="spell">DI</abbr> are initially covered by <abbr class="spell">SSI</abbr> as well. <abbr class="spell">SSI</abbr> enhances the bundle of available cash benefits through two mechanisms: (1) <abbr class="spell">SSI</abbr> provides cash payments during the <span class="nobr">5-month</span> <abbr class="spell">DI</abbr> waiting period, and (2) <abbr class="spell">SSI</abbr> supplements the <abbr class="spell">DI</abbr> benefit after the <abbr class="spell">DI</abbr> waiting period for people whose initial <abbr class="spell">SSI</abbr> payment is larger than the <abbr class="spell">DI</abbr> benefit.</p>
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<p>We find that the role of <abbr class="spell">SSI</abbr> cash payments is temporary for most of those who are initially covered by both <abbr class="spell">SSI</abbr> and <abbr class="spell">DI</abbr>: They would receive <abbr class="spell">SSI</abbr> during the <abbr class="spell">DI</abbr> waiting period, but would lose <abbr class="spell">SSI</abbr> eligibility afterwards because the higher <abbr class="spell">DI</abbr> benefit completely offsets the <abbr class="spell">SSI</abbr> benefit. However, a smaller group of <abbr class="spell">DI</abbr> beneficiaries with low <abbr class="spell">DI</abbr> benefit levels would continue to be covered by both <abbr class="spell">SSI</abbr> and <abbr class="spell">DI</abbr> after the <abbr class="spell">DI</abbr> waiting period because the relatively low <abbr class="spell">DI</abbr> benefit would not completely offset the <abbr class="spell">SSI</abbr> benefit.</p>
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<p>The third major finding is that interactions with other programs also substantially enhance the safety net. The most important interactions involve health insurance coverage. In the working-age population, Medicare is available to DI beneficiaries, but only after a <span class="nobr">24-month</span> waiting period. By contrast, <abbr class="spell">SSI</abbr> is an important pathway to Medicaid benefits for severely disabled adults with limited income and resources and has no waiting period. <abbr class="spell">SSI</abbr> can provide a pathway to health insurance coverage during the <span class="nobr">24-month</span> Medicare waiting period for some <abbr class="spell">DI</abbr> beneficiaries through providing access to Medicaid.</p>
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<p>Interactions with other programs, such as Temporary Assistance for Needy Families (<abbr>TANF</abbr>), Food Stamp, Unemployment Insurance (<abbr class="spell">UI</abbr>), workers' compensation (<abbr class="spell">WC</abbr>), and veterans' disability programs, modify the role of <abbr class="spell">DI</abbr> and <abbr class="spell">SSI</abbr> in protecting people against the adverse financial effects of disablement. The nature of the interactions with other programs differs depending on individual circumstances. Employment-related programs (including <abbr class="spell">UI</abbr>, <abbr class="spell">WC</abbr>, and veteran's disability programs) are particularly important for those who are covered by <abbr class="spell">DI</abbr>. By contrast, the means-tested programs (including <abbr>TANF</abbr> and Food Stamp) are more important for those who would be eligible for <abbr class="spell">SSI</abbr>.</p>
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<p>In conclusion, <abbr class="spell">SSI</abbr> plays a substantial role in protecting working-age people against the adverse financial consequences of disablement through three mechanisms: (1) providing coverage to many who are not <abbr class="spell">DI</abbr> insured; (2) providing additional cash benefits to many who are <abbr class="spell">DI</abbr> insured and also covered by <abbr class="spell">SSI</abbr>; and (3) enhancing the social safety net by interacting with other programs, most notably Medicaid. Through these mechanisms, the role of <abbr class="spell">SSI</abbr> is substantial enough that it cannot be safely ignored in econometric and policy research on <abbr class="spell">DI</abbr>.</p>
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<h2>Introduction</h2>
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<p>This article analyzes the role of the Supplemental Security Income (<abbr class="spell">SSI</abbr>) and Social Security Disability Insurance (<abbr class="spell">DI</abbr>) programs in protecting the working-age population against the adverse financial consequences of becoming disabled. Our focus is not limited to current participants in these two major disability programs administered by the Social Security Administration (<abbr class="spell">SSA</abbr>). We take a broader view. We are interested in the extent to which these two programs insure against the financial consequences of disability for the entire working-age population in the United States, most of whom currently are neither disabled nor <abbr class="spell">SSI</abbr> or <abbr class="spell">DI</abbr> participants. Adapting a term frequently used in the health care financing literature—insurance coverage—our focus here is "disability benefit coverage." Specifically, we are focusing on the coverage provided by the two major public disability programs in the United States: <abbr class="spell">DI</abbr> and <abbr class="spell">SSI</abbr>. We define a person as "covered" by <abbr class="spell">DI</abbr> if the person is "<abbr class="spell">DI</abbr> insured." Likewise, a person is "covered" by <abbr class="spell">SSI</abbr> for the working-aged if he or she meets the <abbr class="spell">SSI</abbr> income and resource screen in the event of potential disablement and meets citizenship and residency requirements. Note that this concept of "coverage" is broader than the concept of program participation. In fact, the bulk of those who are covered by <abbr class="spell">SSI</abbr> or <abbr class="spell">DI</abbr> are not current participants because they either have not applied for one or both, or have applied but do not currently meet the strict disability definition of these programs.</p>
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<p>The risk of becoming disabled faced by the working-age population is difficult to determine; however, some information is given by observed patterns of <abbr class="spell">DI</abbr> and <abbr class="spell">SSI</abbr> participation over the working-age portion of the life cycle. Chart 1 shows the proportion of individuals in different age groups that has ever participated in <abbr class="spell">DI</abbr> or <abbr class="spell">SSI</abbr> by 1996.<sup><a href="#mn1" id="mt1">1</a></sup> The chart shows how the proportions vary by educational attainment. The risk of participation increases with age for all education-level groups, but the increase is most striking for those with less than a high school education. Among those aged <span class="nobr">60–64</span> in 1996, nearly 35 percent had at some point participated in the <abbr class="spell">DI</abbr> or <abbr class="spell">SSI</abbr> program during their lifetime. These data suggest that the risk of disablement during the working-age years may be substantial. Thus it is important to learn about the degree to which the working-age population is protected against the financial risks of disablement. This very issue is the focus of our article.</p>
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<div class="chartCenter">
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<div class="chart700" id="chart1">
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<div class="title">Chart 1.<br>Percent ever participated in <abbr class="spell">DI</abbr>/<abbr class="spell">SSI</abbr> by November 1996 among subgroups, by educational attainment and age</div>
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<div class="scrollChart"><img src="v68n1p1_chart01.gif" alt="Line chart with tabular version below." width="700" height="355" /></div>
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<div class="table altTable"><a class="altToggle" href="">Show as table</a>
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<table>
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<caption><span class="tableNumber">Table equivalent for Chart 1. </span>Percent ever participated in <abbr class="spell">DI</abbr>/<abbr class="spell">SSI</abbr> by November 1996 among subgroups, by educational attainment and age (in percent)</caption>
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<colgroup span="1" style="width:8em"></colgroup>
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<colgroup span="1" style="width:12em"></colgroup>
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<colgroup span="1" style="width:8em"></colgroup>
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<colgroup span="1" style="width:12em"></colgroup>
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<thead>
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<tr>
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<th class="stubHeading" scope="col">Age in 1996</th>
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<th scope="col">Less than high school</th>
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<th scope="col">High school</th>
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<th scope="col">More than high school</th>
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</tr>
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</thead>
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<tbody>
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<tr>
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<th class="stub0" scope="row">Less than 20</th>
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<td>4.94</td>
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<td>1.01</td>
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<td>0.40</td>
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</tr>
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<tr>
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<th class="stub0 nobr" scope="row">20–24</th>
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<td>7.73</td>
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<td>3.96</td>
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<td>0.58</td>
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</tr>
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<tr>
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<th class="stub0 nobr" scope="row">25–29</th>
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<td>6.59</td>
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<td>4.41</td>
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<td>0.90</td>
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</tr>
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<tr>
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<th class="stub0 nobr" scope="row">30–34</th>
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<td>8.78</td>
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<td>2.97</td>
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<td>0.70</td>
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</tr>
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<tr>
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<th class="stub0 nobr" scope="row">35–39</th>
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<td>12.51</td>
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<td>4.46</td>
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<td>1.78</td>
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</tr>
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<tr>
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<th class="stub0 nobr" scope="row">40–44</th>
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<td>14.44</td>
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<td>5.25</td>
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<td>2.12</td>
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</tr>
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<tr>
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<th class="stub0 nobr" scope="row">45–49</th>
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<td>19.06</td>
|
|
<td>6.58</td>
|
|
<td>2.74</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0 nobr" scope="row">50–54</th>
|
|
<td>20.42</td>
|
|
<td>7.29</td>
|
|
<td>4.59</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0 nobr" scope="row">55–59</th>
|
|
<td>27.14</td>
|
|
<td>10.62</td>
|
|
<td>5.74</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0 nobr" scope="row">60–64</th>
|
|
<td>34.64</td>
|
|
<td>10.28</td>
|
|
<td>7.08</td>
|
|
</tr>
|
|
</tbody>
|
|
<tfoot>
|
|
<tr>
|
|
<td class="noNotes" colspan="4"> </td>
|
|
</tr>
|
|
</tfoot>
|
|
</table>
|
|
</div>
|
|
<div class="firstNote">SOURCE: Survey of Income and Program Participation matched to Social Security Administration administrative records, November 1996.</div>
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|
<div class="lastNote">NOTE: <abbr class="spell">DI</abbr> = Disability Insurance; <abbr class="spell">SSI</abbr> = Supplemental Security Income.</div>
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|
</div>
|
|
</div>
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|
<p>The size of the population that is currently covered by the <abbr class="spell">DI</abbr> program against the financial consequences of becoming disabled, called the "<abbr class="spell">DI</abbr>-insured population," is routinely estimated by the Social Security Administration. In contrast, there have been no previous studies to estimate the size and characteristics of the working-age population that is covered by the <abbr class="spell">SSI</abbr> program. In this study we provide the first estimates of the size and characteristics of the working-age population that is covered by <abbr class="spell">SSI</abbr>, <abbr class="spell">DI</abbr>, or both.</p>
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<p>The rest of the article is organized as follows. In the next section we provide some programmatic background. The outline of the research questions follows, with a brief assessment of the extent to which they have been addressed by previous literature. This is followed by a description of the data and methodology. The substantive results are presented next, addressing (a) prevalence of <abbr class="spell">DI</abbr>/<abbr class="spell">SSI</abbr> coverage, (b) characteristics of population segments defined by patterns of coverage, and (c) access to alternative or complementary safety net protections. Finally, we identify issues for future research.</p>
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<h2>Programmatic Background</h2>
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|
<p>To qualify for <abbr class="spell">DI</abbr> benefits in the event of disablement one has to be "<abbr class="spell">DI</abbr> insured." <abbr class="spell">DI</abbr>-insured status is conditioned on the history of covered earnings. In general, <abbr class="spell">DI</abbr>-insured status requires both 20 quarters of coverage in the previous 10 years and a quarter of coverage for each year after the person reaches age 21.<sup><a href="#mn2" id="mt2">2</a></sup> The former requirement is modified for people younger than age 31, but generally follows the pattern of requiring one quarter of coverage for each two calendar quarters that have elapsed since the age of 21. A quarter of coverage is currently defined as a specific amount of earnings and was equivalent to $640 in 1996. Importantly, the <abbr class="spell">DI</abbr> program is not means tested.</p>
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<p>The <abbr class="spell">SSI</abbr> program provides income support for some economically vulnerable aged, disabled, or blind persons and couples. In contrast to <abbr class="spell">DI</abbr>, <abbr class="spell">SSI</abbr> is means-tested: Program rules include an income and resource test. Federal <abbr class="spell">SSI</abbr> payments are calculated as the difference between the federal benefit rate (<abbr class="spell">FBR</abbr>) and countable income.<sup><a href="#mn3" id="mt3">3</a></sup> All elderly persons satisfying the financial eligibility rules are categorically eligible for <abbr class="spell">SSI</abbr> payments. In contrast, working-age persons need to meet <abbr class="spell">SSA</abbr>'s disability screen as well to qualify.</p>
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<p>The <abbr class="spell">SSI</abbr> disability screen for the working-aged is identical to the screen used for the <abbr class="spell">DI</abbr> program. Under both programs, for a person to be considered disabled, he or she should not be able to engage in any substantial gainful activity (<abbr class="spell">SGA</abbr>)<sup><a href="#mn4" id="mt4">4</a></sup> because of a medically determined impairment that is expected either to result in death or last for at least 12 months. The impairment must be the primary reason for the inability to engage in <abbr class="spell">SGA</abbr>. This is a strict definition of disability in that the person must be not only unable to do previous work, but also any other type of work considering age, education, and work experience. It does not matter whether such work exists in the person's immediate area, whether there is a job vacancy, or whether the individual would be hired.</p>
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<p>Although <abbr class="spell">SSI</abbr> payments have no effect on <abbr class="spell">DI</abbr> benefits, Social Security (Old-Age, Survivors, and Disability Insurance, or <abbr class="spell">OASDI</abbr>), is treated as countable income by <abbr class="spell">SSI</abbr>. Thus in most cases <abbr class="spell">DI</abbr> benefits reduce the size of <abbr class="spell">SSI</abbr> payments the person (or couple) would otherwise be financially eligible for on a dollar-for-dollar basis.<sup><a href="#mn5" id="mt5">5</a></sup> Interactions between <abbr class="spell">SSI</abbr> and <abbr class="spell">OASDI</abbr> also arise from other program features. Specifically, <abbr class="spell">SSI</abbr> payments start immediately upon meeting the means-test criteria and qualifying as categorically disabled, and <abbr class="spell">DI</abbr> benefits only begin after a <span class="nobr">5-month</span> waiting period from disability onset. Likewise, although <abbr class="spell">SSI</abbr> awardees in most cases immediately qualify for Medicaid,<sup><a href="#mn6" id="mt6">6</a></sup> there is a <span class="nobr">24-month</span> Medicare waiting period following entitlement to benefits among <abbr class="spell">DI</abbr> awardees. In fact, this may be better described as a <span class="nobr">29-month</span> waiting period because the <span class="nobr">5-month</span> <abbr class="spell">DI</abbr> waiting period and the <span class="nobr">24-month</span> Medicare waiting period are additive. Thus, <abbr class="spell">SSI</abbr> cash payments and associated Medicaid eligibility may enhance the <abbr class="spell">DI</abbr> safety net. The timing of applications and awards may also affect the potential benefits available from the different programs. For example, if the application occurs months after the onset of qualifying disabilities, <abbr class="spell">DI</abbr> benefits may be retroactively awarded for a period up to 12 months before the application date. By contrast, retroactive payments are not allowed for months before application in the <abbr class="spell">SSI</abbr> program.<sup><a href="#mn7" id="mt7">7</a></sup> The timing of final award decisions also affects the de facto availability of benefits. The wait for an award decision can be quite lengthy. For example, successful appeals of denials may take 500 days or more and result in retroactive lump-sum payments. According to <abbr class="spell">SSA</abbr>, the agency performance target for average processing time for hearing decisions was 524 days for fiscal year (<abbr class="spell">FY</abbr>) 2007, with an average of 541 days projected for <abbr class="spell">FY</abbr> 2008 (<abbr class="spell">SSA</abbr> 2007b).</p>
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|
<p>Both the size of the <abbr class="spell">DI</abbr> program and the disability component of the <abbr class="spell">SSI</abbr> program have increased since the 1970s. From 1975 through 2005, the number of <abbr class="spell">DI</abbr> beneficiaries increased from 2.5 million to 6.5 million. Similarly, the number of working-age <abbr class="spell">SSI</abbr> recipients (including both disabled and blind) increased from 1.8 million to 4.1 million over the same period. In contrast, the aged component of the <abbr class="spell">SSI</abbr> program has been decreasing in size; the number of <abbr class="spell">SSI</abbr> recipients aged 65 or older decreased from 2.5 million to 2 million over this period.<sup><a href="#mn8" id="mt8">8</a></sup></p>
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|
<h2>Research Questions and Previous Literature</h2>
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|
<p>The purpose of this article is to fill a gap in the literature by addressing the role of <abbr class="spell">SSI</abbr> in supplementing <abbr class="spell">DI</abbr> in terms of population coverage and the bundle of benefits available in case of severe disablement. We address three specific research questions focusing on (1) coverage provided by the <abbr class="spell">SSI</abbr> and <abbr class="spell">DI</abbr> programs in the working-age population, (2) characteristics of subpopulations identified by various patterns of access to <abbr class="spell">SSI</abbr> and/or <abbr class="spell">DI</abbr>, and (3) access to alternative or complementary safety net protections. We discuss each of these briefly here.</p>
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|
<p>Our first research question addresses the relative size of the working-age population that is covered by the <abbr class="spell">SSI</abbr> and <abbr class="spell">DI</abbr> programs in the event of disablement. Specifically, we are interested in <abbr class="spell">SSI</abbr>'s role in providing coverage for some people who are not currently <abbr class="spell">DI</abbr>-insured. In addition, we are interested in the role of <abbr class="spell">SSI</abbr> in enhancing cash benefits among those who have access to both <abbr class="spell">SSI</abbr> and <abbr class="spell">DI</abbr>. We also briefly explore the overall importance of these safety net protections during different time horizons using a <span class="nobr">10-year</span> follow-up window. This angle—the probability distribution of the risk of disablement—is relevant in that the overall value of safety net protections is a multiplicative function of three factors: the probability of coverage, the value of the benefit bundle conditional on coverage, and the probability of disablement conditional on coverage. The second research question addresses how the characteristics of the subpopulations defined by various patterns of <abbr class="spell">DI</abbr> and/or <abbr class="spell">SSI</abbr> coverage differ in terms of demographics, health and disabilities, and economic well-being. Our third research question addresses access to alternative or complementary safety net protections. We are particularly interested in (1) access to other sources of cash income in the event of disablement and (2) access to Medicaid and Medicare, as well as other sources of health insurance. The role of Medicaid is of particular importance here. <abbr class="spell">SSI</abbr> may enhance the safety net for the <abbr class="spell">DI</abbr>-insured not only directly (cash payments), but also indirectly, through facilitating access to Medicaid.</p>
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|
<p>This analysis fills an important gap in the research literature by focusing on the role of <abbr class="spell">SSI</abbr> and how it complements <abbr class="spell">DI</abbr>. Previous studies tend to concentrate on either one program or the other. For example, there have been excellent overviews of the <abbr class="spell">DI</abbr> program, such as that by Bound and Burkhauser (1999), but this literature has largely ignored <abbr class="spell">SSI</abbr>. Another gap filled by our article is its focus on <abbr class="spell">SSI</abbr> for working-age disabled persons. Most previous <abbr class="spell">SSI</abbr> studies have focused primarily on the elderly, such as those of McGarry (1996, 2002), Davies (2002), Davies and others (2002, 2004), and Rupp, Strand, and Davies (2003).</p>
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|
<p>However, while the literature is sparse, there are a few previous studies with more direct relevance to the subject of our article. Mitchell and Phillips (2000, 2001) provide interesting analyses of the vulnerability to potential disablement among the working-age population, particularly the near elderly, by analyzing factors affecting <abbr class="spell">DI</abbr>-insured status or the lack of it. However, they do not explicitly account for the role of <abbr class="spell">SSI</abbr>. Rupp and Scott (1998) provide the first estimate of <abbr class="spell">SSI</abbr> financial eligibility among the working-age population and analyze some interactions between <abbr class="spell">SSI</abbr> and <abbr class="spell">DI</abbr>. Rupp and Davies (2004) look at the role of <abbr class="spell">SSI</abbr> and <abbr class="spell">DI</abbr> in providing a safety net for economically vulnerable segments of the working-age population and find that <abbr class="spell">SSA</abbr>'s disability programs play a much larger role over the individual life cycle than one might infer from cross-sectional rates of participation. Meyer and Mok (2006) also provide a life-cycle perspective, analyzing the relationship between disability event history, earnings, income, and consumption.</p>
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|
<p>Burkhauser and Wittenburg (1996) look at interactions between <abbr class="spell">DI</abbr>, <abbr class="spell">SSI</abbr>, and other disability programs, as well as Medicaid and Medicare. Honeycutt (2004) analyzes program and benefit paths to <abbr class="spell">DI</abbr>. Gruber and Kubik (2002) focus on the role of health insurance coverage in the <abbr class="spell">DI</abbr> application decision. Riley (2006) analyzes the role of Medicaid during the <span class="nobr">24-month</span> Medicare waiting period. Foote and Hogan (2001) and Riley, Lubitz, and Zhang (2003) also focus on health care, disabilities, and health care cost among working-age Medicare beneficiaries.</p>
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|
<p>Our study builds on previous efforts that analyze the role of <abbr class="spell">SSI</abbr> and <abbr class="spell">DI</abbr> as safety net protections for the working-age population by comprehensively looking at the interactions between the two programs in providing coverage for disablement. Thus, our article breaks new ground in terms of estimating the size and characteristics of the working-age population covered by <abbr class="spell">SSA</abbr>'s two disability programs, as well as by taking a broader view of important program interactions, most notably with Medicaid and Medicare.</p>
|
|
<h2>Data and Methodology</h2>
|
|
<p>The source of data for this study is the 1996 panel of the Survey of Income and Program Participation (<abbr>SIPP</abbr>) matched at the individual level to Social Security administrative records. The analysis sample is limited to persons aged <span class="nobr">18–64</span> in the United States noninstitutional population in November 1996. The source of date of death is <abbr class="spell">SSA</abbr>'s Social Security number identification (Numident) system.<sup><a href="#mn9" id="mt9">9</a></sup> <abbr class="spell">DI</abbr> and <abbr class="spell">SSI</abbr> beneficiary status is defined on the basis of current payment status in November 1996 using information from <abbr class="spell">SSA</abbr>'s Master Beneficiary Record (<abbr class="spell">MBR</abbr>) and the Supplemental Security Record (<abbr class="spell">SSR</abbr>). The data are weighted to account for the complex <abbr>SIPP</abbr> sample design and for the lack of valid Social Security numbers for some <abbr>SIPP</abbr> sample members. The weighted estimates are designed to provide unbiased estimates of the relevant population values. We calculate standard error estimates that use a simple adjustment to account for the complex <abbr>SIPP</abbr> sample design effect (<abbr class="spell">DEFF</abbr>).<sup><a href="#mn10" id="mt10">10</a></sup></p>
|
|
<p>Our research methodology is based on three components:</p>
|
|
<ol>
|
|
<li>Measuring <abbr class="spell">SSI</abbr> financial eligibility status and <abbr class="spell">DI</abbr>-insured status using the <abbr class="spell">SSA</abbr> Office of Retirement and Disability Policy's Financial Eligibility Model (<abbr class="spell">FEM</abbr>),</li>
|
|
<li>Modifying the <abbr class="spell">FEM</abbr> to account for the role of own earnings in establishing both categorical and <abbr class="spell">SSI</abbr> financial eligibility for the working-age population, and</li>
|
|
<li>Modifying the concept of concurrent <abbr class="spell">DI</abbr> and <abbr class="spell">SSI</abbr> coverage to account for the dynamic interaction of the two programs arising from the <span class="nobr">5-month</span> <abbr class="spell">DI</abbr> waiting period.</li>
|
|
</ol>
|
|
<p>Next, we briefly address the first of these components, which is a relatively simple adaptation of methods that have been used in other studies, and then discuss the last two, more innovative, aspects of our methodology in greater detail.</p>
|
|
<h3>Measurement of <abbr class="spell">SSI</abbr> Financial Eligibility Status and <abbr class="spell">DI</abbr>-Insured Status</h3>
|
|
<p>The establishment of <abbr class="spell">SSI</abbr> financial eligibility status is based on a modified version of the <abbr class="spell">FEM</abbr>, which is a static simulation model focusing on <abbr class="spell">SSI</abbr> financial eligibility, participation, and the assessment of various <abbr class="spell">SSI</abbr> policy options. The key elements of the <abbr class="spell">FEM</abbr> are described in Davies and others (2002). The basic structure of the <abbr class="spell">FEM</abbr> is similar to the <abbr class="spell">SSI</abbr> model that was developed by McGarry (1996, 2002) except that the <abbr class="spell">FEM</abbr> utilizes administrative records matched to the survey data and contains a more detailed algorithm to establish <abbr class="spell">SSI</abbr> financial eligibility. The previous applications of the <abbr class="spell">FEM</abbr> have focused on the elderly. A key element of the <abbr class="spell">FEM</abbr>—as applied to the aged—is a financial eligibility calculator that estimates potential <abbr class="spell">SSI</abbr> income and resource eligibility for any sample member regardless of actual program participation. The eligibility calculator is based on detailed <abbr class="spell">SSI</abbr> income and resource eligibility rules applied to survey data on income and assets from the <abbr>SIPP</abbr>.<sup><a href="#mn11" id="mt11">11</a></sup> For those persons deemed financially eligible for <abbr class="spell">SSI</abbr>, the <abbr class="spell">FEM</abbr> calculates expected (hypothetical) federal <abbr class="spell">SSI</abbr> payments based on the applicable federal benefit rate (individual or couple unit) and countable income from the <abbr>SIPP</abbr>.<sup><a href="#mn12" id="mt12">12</a></sup></p>
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|
<p>We modified the <abbr class="spell">FEM</abbr> to add a <abbr class="spell">DI</abbr> benefit calculator that applies Social Security program rules to each sample member's earnings history as reflected in the Summary Earnings Record. The calculator establishes <abbr class="spell">DI</abbr>-insured status and computes expected (hypothetical) <abbr class="spell">DI</abbr> benefit amounts for all sample members aged <span class="nobr">18–64</span>, regardless of actual program participation. The calculator mimics program rules in determining <abbr class="spell">DI</abbr>-insured status based on "quarters of coverage." We note that <abbr class="spell">DI</abbr>-insured status and categorical eligibility as disabled are totally independent variables, which contrasts with the <abbr class="spell">SSI</abbr> program, where financial eligibility and categorical eligibility based on disability are interrelated. We explain this difference below.</p>
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|
<h3>The Substantial Gainful Activity Test and <abbr class="spell">SSI</abbr> Financial Eligibility</h3>
|
|
<p>Our first innovation is to account for the role of own earnings in establishing <abbr class="spell">SSI</abbr> coverage among the working-age population. The relationship between the financial and categorical eligibility variables needs to be carefully considered for the working-age population. Among the elderly, <abbr class="spell">SSI</abbr> financial eligibility is independent of categorical eligibility, since all elderly citizens of the United States who meet minimum residency requirements are categorically eligible for <abbr class="spell">SSI</abbr>. In contrast, among the working-age population, the reference person's <i>own</i> earnings affect both <abbr class="spell">SSI</abbr> income eligibility and categorical eligibility as disabled in the initial eligibility determination because of the <abbr class="spell">SGA</abbr> test. The <abbr class="spell">SGA</abbr> test results in the presumptive denial of disability benefits for applicants with <i>own</i> earnings higher than the <abbr class="spell">SGA</abbr> threshold. As we explain below, this interdependence of the two eligibility screens warrants a modification of the <abbr class="spell">SSI</abbr> financial eligibility algorithm.</p>
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|
<p>To address the role of <abbr class="spell">SGA</abbr>-level <i>own</i> earnings in affecting <abbr class="spell">SSI</abbr> financial eligibility, we construct two distinct measures of eligibility. Both measures use the same basis for determining resource eligibility but differ in the measurement of income eligibility. One is the conventional measure of income eligibility based on <i>current</i> countable income, which reflects income eligibility that is conditional on current earnings observed for the reference month. Our second measure is designed to capture <i>potential</i> income eligibility in the hypothetical event of categorically qualifying disablement. We conservatively assume that <i>own</i> earnings under this second scenario are "<i><abbr class="spell">SGA</abbr>-constrained</i>." For people whose <i>current</i> earnings are below <abbr class="spell">SGA</abbr>, there is no difference between "current" and "potential" <abbr class="spell">SSI</abbr> income eligibility. For people whose <i>current</i> earnings are above <abbr class="spell">SGA</abbr>, a potential disability shock severe enough to result in categorical eligibility as disabled requires a drop in <i>own</i> earnings to below-<abbr class="spell">SGA</abbr> levels. This earnings drop, in turn, might result in potential <abbr class="spell">SSI</abbr> income eligibility for people whose (predisability) current earnings would result in failure to meet the income test.<sup><a href="#mn13" id="mt13">13</a></sup> Our "<i>potential <abbr class="spell">SSI</abbr> financial eligibility</i>" measure simply reflects hypothetical <abbr class="spell">SSI</abbr> income eligibility that is conditional on <abbr class="spell">SGA</abbr>-constrained <i>own</i> earnings combined with the conventional measure of resource eligibility.</p>
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|
<p>In this recalculation we assume all other sources of income and resources are unchanged. Thus, we assume away potential changes in spousal labor supply, spend down of resources, qualifying and starting to receive employer-sponsored pension benefits, and so on. The various topics are all worthy of further research, but we believe that the shift to <abbr class="spell">SGA</abbr>-constrained earnings is distinct in that it is directly related to the <abbr class="spell">SSA</abbr> definition of categorical disability and also to <abbr class="spell">SSI</abbr> income eligibility. Therefore, it is of primary importance. In the remainder of this article, unless otherwise stated, the term "<abbr class="spell">SSI</abbr> eligible" refers to people who are "covered" by the <abbr class="spell">SSI</abbr> program in the sense that their potential income under the assumption of <abbr class="spell">SGA</abbr>-constrained earnings would qualify them for <abbr class="spell">SSI</abbr> in the event of severe disablement.</p>
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|
<p>Our approach is supported by some early findings from an emerging literature on the various effects of "health shocks" that use longitudinal data that are better suited to consider complex interactions. Coile (2004), for example, finds that health shocks result in dramatic reduction of the labor supply of the affected worker, but finds that the hypothesized spousal "added-worker effect" is small for men, and finds no evidence for women. Coile notes that the direction of the spousal labor supply effect is ambiguous for a variety of reasons including complementarity of spousal leisure and home production in the form of caregiving.</p>
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<h3>The <span class="nobr">5-Month</span> <abbr class="spell">DI</abbr> Waiting Period and Dynamic Program Interactions: Serial and Joint Eligibility</h3>
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<p>Our second methodological innovation is warranted by the existence of the <span class="nobr">5-month</span> <abbr class="spell">DI</abbr> waiting period, which complicates the determination of <abbr class="spell">SSI</abbr> financial eligibility because <abbr class="spell">DI</abbr> benefits need to be considered in establishing income eligibility for <abbr class="spell">SSI</abbr>. Thus <abbr class="spell">SSI</abbr> financial eligibility status may be different during the <span class="nobr">5-month</span> <abbr class="spell">DI</abbr> waiting period than after <abbr class="spell">DI</abbr> benefits begin. <abbr class="spell">SSI</abbr> coverage is relevant in terms of the value of safety net protections not only because of the potential <abbr class="spell">SSI</abbr> cash payment during the <span class="nobr">5-month</span> <abbr class="spell">DI</abbr> waiting period and beyond, but also because of the possibility of Medicaid coverage both during the <span class="nobr">5-month</span> <abbr class="spell">DI</abbr> waiting period and during the subsequent <span class="nobr">24-month</span> Medicare waiting period. <abbr class="spell">SSI</abbr> recipients are categorically eligible for Medicaid under most circumstances. In addition, Medicaid eligibility may continue even if <abbr class="spell">SSI</abbr> benefits discontinue as a result of <abbr class="spell">DI</abbr> benefits that may begin after the <span class="nobr">5-month</span> waiting period. For these reasons, we have considered the dynamic relationship between the <span class="nobr">5-month</span> <abbr class="spell">DI</abbr> waiting period and <abbr class="spell">SSI</abbr> financial eligibility in developing a refined classification of "concurrent" <abbr class="spell">DI</abbr> and <abbr class="spell">SSI</abbr> eligibility.</p>
|
|
<p>To address these interactions we consider what happens after the initial determination of eligibility to receive <abbr class="spell">DI</abbr> and <abbr class="spell">SSI</abbr> benefits. Because the categorical eligibility criteria are identical for the two programs (except for a lack of the <abbr class="spell">SGA</abbr> test for <abbr class="spell">SSI</abbr> blind individuals), a single process determines categorical eligibility as disabled. As Chart 2 shows, those persons who pass the <abbr class="spell">SSA</abbr> disability screen can be sorted into three groups by financial eligibility for <abbr class="spell">SSI</abbr> and <abbr class="spell">DI</abbr> benefits: <abbr class="spell">SSI</abbr>-only, concurrent, and <abbr class="spell">DI</abbr>-only. Assuming acceptance of <abbr class="spell">SSI</abbr> payments among those eligible and no changes other than the passage of time after initial award,<sup><a href="#mn14" id="mt14">14</a></sup> the chart shows the dynamic relationships in the benefit determination process. The financial eligibility and expected <abbr class="spell">SSI</abbr> payments of <abbr class="spell">SSI</abbr>-only awardees (left side of chart) are unaffected by the <span class="nobr">5-month</span> <abbr class="spell">DI</abbr> waiting period: <abbr class="spell">SSI</abbr>-only payments are to be rendered immediately following the onset of a qualifying disability. In contrast, <abbr class="spell">DI</abbr>-only awardees (right side) do not receive any disability benefits during the first <span class="nobr">5-months</span> after onset of disability, and receive <abbr class="spell">DI</abbr>-only benefits afterward.</p>
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<div class="chartCenter">
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<div class="chart700" id="chart2">
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<div class="title">Chart 2.<br>Simplified DI and SSI benefit stream determination conditional on passing the SSA disability screen</div>
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<div class="scrollChart"><img src="v68n1p1_chart02.gif" alt="Flowchart with text description below." width="700" height="722" /></div>
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<div class="altText"><a class="altTextToggle" href="">Show text description</a>
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<div class="align-left">
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<p class="noindent"><b>Text description for Chart 2. Simplified <abbr class="spell">DI</abbr> and <abbr class="spell">SSI</abbr> benefit stream determination conditional on passing the <abbr class="spell">SSA</abbr> disability screen</b></p>
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<p class="noindent">Chart 2 is a flow chart with eight labeled boxes linked by arrows and dotted lines. There are three starting points in the flow chart. The flow is one-directional; that is, none of the arrows point back to a previous box, although one arrow laterally connects a box to a flow that descends from a different starting point.</p>
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|
<p class="noindent">The starting points represent the different types of benefits. The benefit types are <abbr class="spell">SSI</abbr>-only, <abbr class="spell">DI</abbr>-only, and concurrent. There are two possible outcomes for concurrent benefit awardees; the other benefit types have only one outcome.</p>
|
|
<p class="noindent">The possible flows originating with each starting point are presented as lists.</p>
|
|
<p class="noindent">Starting point A</p>
|
|
<ol>
|
|
<li>Benefit type: <abbr class="spell">SSI</abbr>-only benefit awardee.</li>
|
|
<li>Outcome: <abbr class="spell">SSI</abbr>-only benefit.</li>
|
|
</ol>
|
|
<p class="noindent">Starting point B</p>
|
|
<ol>
|
|
<li>Benefit type: <abbr class="spell">DI</abbr>-only benefit awardee.</li>
|
|
<li>Dotted-line: <span class="nobr">5-month</span> <abbr class="spell">DI</abbr> waiting period.</li>
|
|
<li>Dotted-line: <span class="nobr">24-month</span> Medicare waiting period.</li>
|
|
<li>Outcome: <abbr class="spell">DI</abbr>-only benefit.</li>
|
|
</ol>
|
|
<p class="noindent">Starting point C, first possible outcome</p>
|
|
<ol>
|
|
<li>Benefit type: Concurrent benefits awardee.</li>
|
|
<li>First intermediate stage: <abbr class="spell">SSI</abbr>-only benefit.</li>
|
|
<li>Conditional stage: If expected <abbr class="spell">DI</abbr> benefit is greater than or equal to the expected <abbr class="spell">SSI</abbr> benefit, awardee is a "serial beneficiary."</li>
|
|
<li>Dotted-line: <span class="nobr">24-month</span> Medicare waiting period.</li>
|
|
<li>Outcome: <abbr class="spell">DI</abbr>-only benefit.</li>
|
|
</ol>
|
|
<p class="noindent">Starting point C, second possible outcome</p>
|
|
<ol>
|
|
<li>Benefit type: Concurrent benefits awardee.</li>
|
|
<li>First intermediate stage: <abbr class="spell">SSI</abbr>-only benefit.</li>
|
|
<li>Conditional stage: If expected <abbr class="spell">DI</abbr> benefit is not greater than or equal to the expected <abbr class="spell">SSI</abbr> benefit, awardee is a "joint beneficiary."</li>
|
|
<li>Outcome: both <abbr class="spell">DI</abbr> and <abbr class="spell">SSI</abbr> benefits.</li>
|
|
</ol>
|
|
</div>
|
|
</div>
|
|
<div class="firstNote">SOURCE: Authors.</div>
|
|
<div class="lastNote">NOTE: <abbr class="spell">DI</abbr> = Disability Insurance; <abbr class="spell">SSI</abbr> = Supplemental Security Income; <abbr class="spell">SSA</abbr> = Social Security Administration.</div>
|
|
</div>
|
|
</div>
|
|
<p>The situation is more complex for concurrent benefit awardees (middle panel). For simplicity we ignore the fact that up to $20 a month of <abbr class="spell">DI</abbr> benefits may be excluded in the determination of <abbr class="spell">SSI</abbr> payments.<sup><a href="#mn15" id="mt15">15</a></sup> Concurrent awardees receive <abbr class="spell">SSI</abbr>-only payments during the <span class="nobr">5-month</span> waiting period, after which time, however, eligibility status and payment amounts are recalculated. Because <abbr class="spell">DI</abbr> benefits are completely offset in the <abbr class="spell">SSI</abbr> income eligibility determination, if expected <abbr class="spell">DI</abbr> benefits are greater than or equal to expected <abbr class="spell">SSI</abbr> payments (assuming the absence of <abbr class="spell">DI</abbr>), <abbr class="spell">SSI</abbr> payments stop as <abbr class="spell">DI</abbr> benefits begin after the <span class="nobr">5-month</span> <abbr class="spell">DI</abbr> waiting period. We call these people "serial beneficiaries" because they transition from <abbr class="spell">SSI</abbr> to <abbr class="spell">DI</abbr> beneficiary status. If the expected <abbr class="spell">DI</abbr> benefit is positive but less than the expected <abbr class="spell">SSI</abbr> payment, a reduced <abbr class="spell">SSI</abbr> payment reflecting the dollar-for-dollar DI offset continues after the 5-month DI waiting period. In effect, the person continues to receive combined cash benefits from the two programs that are equal to the <abbr class="spell">SSI</abbr> payment during the <abbr class="spell">DI</abbr> waiting period.<sup><a href="#mn16" id="mt16">16</a></sup> We refer to this second subgroup of concurrent beneficiaries as "joint beneficiaries."</p>
|
|
<p>An important caveat in interpreting Chart 2 is that it assumes disability application immediately upon the onset of a qualifying disability. However, unpublished Office of Retirement and Disability Policy tabulations and preliminary results from ongoing research indicate that this assumption may not hold in many cases. The implications differ by type of coverage. As noted previously, <abbr class="spell">SSI</abbr> rules prohibit retroactive payments for months before disability application and therefore potential <abbr class="spell">SSI</abbr> benefits are in effect forfeited. In contrast, <abbr class="spell">DI</abbr> benefits are payable for up to 12 months before application depending on the date of disability onset established by <abbr class="spell">SSA</abbr>. As a consequence, the portion of the <abbr class="spell">DI</abbr> waiting period for the post application period may be reduced or completely eliminated. This implies that the length of <i>serial</i> beneficiary status is reduced, or the applicant appears as <abbr class="spell">DI</abbr>-only as a result of forfeiting potential <abbr class="spell">SSI</abbr> payments because of the late date of application.</p>
|
|
<p>While Chart 2 illustrates what happens conditional on the establishment of categorical eligibility as disabled and benefit award, the underlying principles also can be used to classify current nonparticipants by coverage-status categories. We assign each sample member into one of the following five potential coverage-status categories:</p>
|
|
<ol>
|
|
<li><abbr class="spell">DI</abbr>-only coverage,</li>
|
|
<li>Serial <abbr class="spell">SSI</abbr>/<abbr class="spell">DI</abbr> coverage,</li>
|
|
<li>Joint <abbr class="spell">SSI</abbr>/<abbr class="spell">DI</abbr> coverage,<sup><a href="#mn17" id="mt17">17</a></sup></li>
|
|
<li><abbr class="spell">SSI</abbr>-only coverage, and</li>
|
|
<li>Neither <abbr class="spell">DI</abbr> nor <abbr class="spell">SSI</abbr> coverage.</li>
|
|
</ol>
|
|
<p>The importance of distinguishing these five groups arises because they represent different patterns of cash safety net coverage. We note that coverage is unaffected by claiming behavior. As a result, the different <abbr class="spell">DI</abbr> and <abbr class="spell">SSI</abbr> program rules concerning onset of disability before application have no relevance for the establishment of coverage status. Membership in the five groups may affect the person's status in terms of noncash benefits as well—most notably, access to Medicaid and Medicare.</p>
|
|
<h2>Empirical Results</h2>
|
|
<p>In this section we provide empirical results addressing the three major study questions: (1) patterns of <abbr class="spell">DI</abbr> and <abbr class="spell">SSI</abbr> coverage, (2) characteristics of the population segments with various patterns of coverage, and (3) access to other safety nets.</p>
|
|
<h3>Patterns of <abbr class="spell">DI</abbr> and <abbr class="spell">SSI</abbr> Coverage</h3>
|
|
<p>The first column of Table 1 shows the basic results using our preferred, adjusted, potential <abbr class="spell">SSI</abbr> eligibility definition. According to our estimates, over one-third of working-age persons (36 percent) is covered by <abbr class="spell">SSI</abbr>.<sup><a href="#mn18" id="mt18">18</a></sup> This compares with our estimate that three-fourths (77 percent) of the working-age population is covered by <abbr class="spell">DI</abbr>.<sup><a href="#mn19" id="mt19">19</a></sup> Of course, there is an overlap because some people may be covered by both programs. The first column in the table provides a more detailed view of the distribution of the working-age population, both by <abbr class="spell">DI</abbr> and <abbr class="spell">SSI</abbr> coverage. Remarkably, the bulk (about two-thirds) of those who are covered by <abbr class="spell">SSI</abbr> are also <abbr class="spell">DI</abbr> insured.<sup><a href="#mn20" id="mt20">20</a></sup></p>
|
|
<div class="table" id="table1">
|
|
<table>
|
|
<caption><span class="tableNumber">Table 1. </span>Distribution of individuals aged <span class="nobr">18–64</span>, by <abbr class="spell">SSI</abbr> financial eligibility and <abbr class="spell">DI</abbr>-insured status based on alternative earnings assumptions, November 1996</caption>
|
|
<colgroup span="1" style="width:15em"></colgroup>
|
|
<colgroup span="2" style="width:8em"></colgroup>
|
|
<thead>
|
|
<tr>
|
|
<th class="stubHeading" rowspan="2" id="c1"><abbr class="spell">SSI</abbr> financial eligibility and<br><abbr class="spell">DI</abbr>-insured status</th>
|
|
<th class="spanner" colspan="2" id="c2"><abbr class="spell">SSI</abbr> income eligibility measure</th>
|
|
</tr>
|
|
<tr>
|
|
<th id="c3" headers="c2">Adjusted <sup>a</sup></th>
|
|
<th id="c4" headers="c2">Unadjusted <sup>b</sup></th>
|
|
</tr>
|
|
</thead>
|
|
<tbody>
|
|
<tr>
|
|
<td></td>
|
|
<th class="panel" colspan="2" id="r1">Percentage distribution <sup>c</sup></th>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r2" headers="r1 c1"><abbr class="spell">DI</abbr>-insured only</th>
|
|
<td headers="r1 r2 c2 c3">53.5</td>
|
|
<td headers="r1 r2 c2 c4">66.6</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r3" headers="r1 c1"></th>
|
|
<td headers="r1 r2 r3 c2 c3">(0.4)</td>
|
|
<td headers="r1 r2 r3 c2 c4">(0.3)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r4" headers="r1 c1"><abbr class="spell">SSI</abbr>-eligible only</th>
|
|
<td headers="r1 r4 c2 c3">12.6</td>
|
|
<td headers="r1 r4 c2 c4">9.3</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r5" headers="r1 c1"></th>
|
|
<td headers="r1 r4 r5 c2 c3">(0.2)</td>
|
|
<td headers="r1 r4 r5 c2 c4">(0.2)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r6" headers="r1 c1">Both <abbr class="spell">DI</abbr> insured and <abbr class="spell">SSI</abbr> eligible</th>
|
|
<td headers="r1 r6 c2 c3">23.5</td>
|
|
<td headers="r1 r6 c2 c4">10.4</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r7" headers="r1 c1"></th>
|
|
<td headers="r1 r6 r7 c2 c3">(0.3)</td>
|
|
<td headers="r1 r6 r7 c2 c4">(0.2)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r8" headers="r1 c1">Neither</th>
|
|
<td headers="r1 r8 c2 c3">10.5</td>
|
|
<td headers="r1 r8 c2 c4">13.7</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r9" headers="r1 c1"></th>
|
|
<td headers="r1 r8 r9 c2 c3">(0.2)</td>
|
|
<td headers="r1 r8 r9 c2 c4">(0.2)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r10" headers="r1 c1">Total percent</th>
|
|
<td headers="r1 r10 c2 c3">100.00</td>
|
|
<td headers="r1 r10 c2 c4">100.00</td>
|
|
</tr>
|
|
<tr>
|
|
<td></td>
|
|
<th class="panel" colspan="2" id="r11">Percent of total <sup>c</sup></th>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r12" headers="r11 c1"><abbr class="spell">SSI</abbr> eligible, including <abbr class="spell">DI</abbr> insured</th>
|
|
<td headers="r11 r12 c2 c3">36.1</td>
|
|
<td headers="r11 r12 c2 c4">19.7</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r13" headers="r11 c1"></th>
|
|
<td headers="r11 r12 r13 c2 c3">(0.3)</td>
|
|
<td headers="r11 r12 r13 c2 c4">(0.3)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r14" headers="r11 c1"><abbr class="spell">DI</abbr> insured, including <abbr class="spell">SSI</abbr> eligible</th>
|
|
<td headers="r11 r14 c2 c3">77.0</td>
|
|
<td headers="r11 r14 c2 c4">77.0</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r15" headers="r11 c1"></th>
|
|
<td headers="r11 r14 r15 c2 c3">(0.3)</td>
|
|
<td headers="r11 r14 r15 c2 c4">(0.3)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r16" headers="r11 c1"><abbr class="spell">SSI</abbr> eligible and/or <abbr class="spell">DI</abbr> insured</th>
|
|
<td headers="r11 r16 c2 c3">89.6</td>
|
|
<td headers="r11 r16 c2 c4">86.3</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r17" headers="r11 c1"></th>
|
|
<td headers="r11 r16 r17 c2 c3">(0.2)</td>
|
|
<td headers="r11 r16 r17 c2 c4">(0.2)</td>
|
|
</tr>
|
|
<tr class="shaded">
|
|
<th class="stub1" id="r18" headers="r11 c1">Total number <sup>d</sup></th>
|
|
<td headers="r11 r18 c2 c3">44,384</td>
|
|
<td headers="r11 r18 c2 c4">44,384</td>
|
|
</tr>
|
|
</tbody>
|
|
<tfoot>
|
|
<tr>
|
|
<td class="firstNote" colspan="3">SOURCE: Survey of Income and Program Participation (<abbr>SIPP</abbr>) matched to Social Security Administration (<abbr class="spell">SSA</abbr>) administrative records, November 1996.</td>
|
|
</tr>
|
|
<tr>
|
|
<td class="note" colspan="3">NOTES: The universe for Table 1 includes both current participants and nonparticipants.</td>
|
|
</tr>
|
|
<tr>
|
|
<td class="note" colspan="3"><abbr class="spell">SSI</abbr> = Supplemental Security Income; <abbr class="spell">DI</abbr> = Disability Insurance.</td>
|
|
</tr>
|
|
<tr>
|
|
<td class="note" colspan="3">a. Own earnings adjusted to account for substantial gainful activity (<abbr class="spell">SGA</abbr>) ceiling of the <abbr class="spell">SSA</abbr> categorical eligibility screen.</td>
|
|
</tr>
|
|
<tr>
|
|
<td class="note" colspan="3">b. Own earnings unadjusted for <abbr class="spell">SGA</abbr> ceiling of the <abbr class="spell">SSA</abbr> categorical eligibility screen.</td>
|
|
</tr>
|
|
<tr>
|
|
<td class="note" colspan="3">c. Weighted. Estimated standard errors in parentheses. The standard error estimates assume a design effect of 2.34 to account for the complex <abbr>SIPP</abbr> sample design (see Census Bureau, 2001, Table 4, <abbr title="page">p.</abbr> 22).</td>
|
|
</tr>
|
|
<tr>
|
|
<td class="lastNote" colspan="3">d. Unweighted number of sample observations.</td>
|
|
</tr>
|
|
</tfoot>
|
|
</table>
|
|
</div>
|
|
<p>Perhaps most relevant is the combined role of <abbr class="spell">SSI</abbr> and <abbr class="spell">DI</abbr>. Mitchell and Phillips (2000) called attention to a substantial gap in <abbr class="spell">DI</abbr>-insured status among near-elderly men and for women in general. Looking at the working-age population as a whole and incorporating the role of the <abbr class="spell">SSI</abbr> program, we find that about 90 percent of the working-age population is covered by either or both programs. One way to look at the role of potential <abbr class="spell">SSI</abbr> financial eligibility is to note that it reduces the proportion of the working-age population that <i>appears</i> uncovered based on <abbr class="spell">DI</abbr> alone from about 25 percent (those who are not <abbr class="spell">DI</abbr>-insured) to roughly 10 percent. Over half (55 percent) of working-age persons who are not covered by <abbr class="spell">DI</abbr><sup><a href="#mn21" id="mt21">21</a></sup> are covered by <abbr class="spell">SSI</abbr>.<sup><a href="#mn22" id="mt22">22</a></sup></p>
|
|
<p>An important group is the almost one-quarter (24 percent) of the working-age population that is covered by both programs. For these people <abbr class="spell">SSI</abbr> enhances the cash safety net protection. As noted in the Data and Methodology section, it is important to distinguish between "serial" and "joint" eligibles because they fundamentally differ in the way that <abbr class="spell">SSI</abbr> supplements the <abbr class="spell">DI</abbr> cash benefit. Chart 3 shows the <i>serial</i> and <i>joint</i> subgroups separately. The vast majority of concurrent eligibles are <i>serially</i> eligible for the two programs (21 percent of the total working-age population), in contrast to the relatively small subgroup of <i>joint</i> eligibles (3 percent of the total working-age population).</p>
|
|
<div class="chartCenter">
|
|
<div class="chart700" id="chart3">
|
|
<div class="title">Chart 3.<br>Percentage distribution of the working-age noninstitutional population, by potential <abbr class="spell">SSI</abbr> financial eligibility and <abbr class="spell">DI</abbr>-insured status, November 1996</div>
|
|
<div class="scrollChart"><img src="v68n1p1_chart03.gif" alt="Pie chart showing DI-insured only equals 53.5%, serial SSI to DI equals 20.8%, joint SSI and DI equals 2.6%, SSI only equals 12.6%, and neither equals 10.5%." width="650" height="359" /></div>
|
|
<div class="firstNote">SOURCE: Survey of Income and Program Participation matched to Social Security Administration administrative records, November 1996.</div>
|
|
<div class="lastNote">NOTE: <abbr class="spell">SSI</abbr> = Supplemental Security Income; <abbr class="spell">DI</abbr> = Disability Insurance.</div>
|
|
</div>
|
|
</div>
|
|
<p>Overall, these findings are consistent with the common view of <abbr class="spell">DI</abbr> as the main pillar of the safety net against the risk of severe disablement among the working-age population. What is new here is the finding that <abbr class="spell">SSI</abbr> plays a large role in supplementing this cash safety net in two principal ways: first, by reducing by half the percentage of the working-age population that is not protected against the adverse financial consequences of disablement; and second, by providing for almost one-third of the <abbr class="spell">DI</abbr>-insured additional <abbr class="spell">SSI</abbr> income to complement <abbr class="spell">DI</abbr> income.</p>
|
|
<h3>Characteristics of Subgroups of Current Nonparticipants by Various Patterns of Coverage</h3>
|
|
<p>What groups of the working-age population are affected by the availability of <abbr class="spell">DI</abbr> and/or <abbr class="spell">SSI</abbr> in the event of a disability? Those who are currently <i>participating</i> in either or both of <abbr class="spell">SSA</abbr>'s disability programs are clearly protected, but form only a small fraction of the working-aged. The bulk of the working-age population consists of current <i>nonparticipants</i>. In this section we focus on the characteristics of the nonparticipant population with various patterns of coverage.</p>
|
|
<p>Table 2 presents demographic characteristics of the five principal groups of <abbr class="spell">DI</abbr> and <abbr class="spell">SSI</abbr> nonparticipants by their patterns of coverage. Four of those groups are covered by <abbr class="spell">DI</abbr> and/or <abbr class="spell">SSI</abbr>, and a fifth group consists of people who are not covered by either program.<sup><a href="#mn23" id="mt23">23</a></sup> The demographic differences between those groups covered by <abbr class="spell">SSI</abbr> and/or <abbr class="spell">DI</abbr> can be understood in the context of associations with life-cycle differences in the attainment of <abbr class="spell">DI</abbr>-insured status, differences in labor force attachment, and other factors affecting <abbr class="spell">SSI</abbr> financial eligibility. For example, we can expect people in their twenties to be less likely to be <abbr class="spell">DI</abbr>-insured than others further ahead in their life cycle and to be the least likely to have accumulated assets above the <abbr class="spell">SSI</abbr> threshold. Likewise, low levels of education are expected to be associated with relatively weak labor force attachment and relatively low earnings, both increasing the probability of <abbr class="spell">SSI</abbr> eligibility and either the lack of <abbr class="spell">DI</abbr>-insured status or expected <abbr class="spell">DI</abbr> benefits low enough to assure long-term dependence on <abbr class="spell">SSI</abbr> in the event of potential disability. People with minor children are also expected to be more likely to be financially eligible for <abbr class="spell">SSI</abbr> than their peers who do not have minor children.</p>
|
|
<div class="table" id="table2">
|
|
<table>
|
|
<caption><span class="tableNumber">Table 2. </span>Demographic characteristics of <abbr class="spell">DI</abbr> and <abbr class="spell">SSI</abbr> nonparticipants aged <span class="nobr">18–64</span>, by potential access to <abbr class="spell">DI</abbr> and/or <abbr class="spell">SSI</abbr>, November 1996</caption>
|
|
<colgroup span="1" style="width:15em"></colgroup>
|
|
<colgroup span="5" style="width:8em"></colgroup>
|
|
<thead>
|
|
<tr>
|
|
<th class="stubHeading" rowspan="3" id="c1">Characteristic</th>
|
|
<th class="spanner" colspan="5" id="c2">Current nonparticipants by potential access to <abbr class="spell">DI</abbr> and/or <abbr class="spell">SSI</abbr> <sup>a</sup></th>
|
|
</tr>
|
|
<tr>
|
|
<th rowspan="2" id="c3" headers="c2"><abbr class="spell">DI</abbr>-insured<br>only</th>
|
|
<th rowspan="2" id="c4" headers="c2"><abbr class="spell">SSI</abbr>-eligible<br>only</th>
|
|
<th class="spanner" colspan="2" id="c5" headers="c2">Concurrent <abbr class="spell">DI</abbr>/<abbr class="spell">SSI</abbr> eligibles</th>
|
|
<th rowspan="2" id="c6" headers="c2">Neither <abbr class="spell">DI</abbr><br>insured nor<br><abbr class="spell">SSI</abbr> eligible</th>
|
|
</tr>
|
|
<tr>
|
|
<th id="c7" headers="c2 c5">Serial <abbr class="spell">SSI</abbr><br>to <abbr class="spell">DI</abbr></th>
|
|
<th id="c8" headers="c2 c5">Joint <abbr class="spell">SSI</abbr><br>and <abbr class="spell">DI</abbr></th>
|
|
</tr>
|
|
</thead>
|
|
<tbody>
|
|
<tr>
|
|
<td></td>
|
|
<th class="panel" colspan="5" id="r1">Percentage distribution <sup>b</sup></th>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r2" headers="r1 c1">Age group</th>
|
|
<td colspan="5"></td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1 nobr" id="r3" headers="r1 r2 c1">18–30</th>
|
|
<td headers="r1 r2 r3 c2 c3">17.1</td>
|
|
<td headers="r1 r2 r3 c2 c4">58.6</td>
|
|
<td headers="r1 r2 r3 c2 c5 c7">45.6</td>
|
|
<td headers="r1 r2 r3 c2 c5 c8">72.8</td>
|
|
<td headers="r1 r2 r3 c2 c6">16.4</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r4" headers="r1 r2 c1"></th>
|
|
<td headers="r1 r2 r3 r4 c2 c3">(0.4)</td>
|
|
<td headers="r1 r2 r3 r4 c2 c4">(1.1)</td>
|
|
<td headers="r1 r2 r3 r4 c2 c5 c7">(0.8)</td>
|
|
<td headers="r1 r2 r3 r4 c2 c5 c8">(2.1)</td>
|
|
<td headers="r1 r2 r3 r4 c2 c6">(0.8)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1 nobr" id="r5" headers="r1 r2 c1">31–45</th>
|
|
<td headers="r1 r2 r5 c2 c3">47.6</td>
|
|
<td headers="r1 r2 r5 c2 c4">28.2</td>
|
|
<td headers="r1 r2 r5 c2 c5 c7">39.3</td>
|
|
<td headers="r1 r2 r5 c2 c5 c8">18.3</td>
|
|
<td headers="r1 r2 r5 c2 c6">39.5</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r6" headers="r1 r2 c1"></th>
|
|
<td headers="r1 r2 r5 r6 c2 c3">(0.5)</td>
|
|
<td headers="r1 r2 r5 r6 c2 c4">(1.0)</td>
|
|
<td headers="r1 r2 r5 r6 c2 c5 c7">(0.8)</td>
|
|
<td headers="r1 r2 r5 r6 c2 c5 c8">(1.8)</td>
|
|
<td headers="r1 r2 r5 r6 c2 c6">(1.1)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1 nobr" id="r7" headers="r1 r2 c1">46–64</th>
|
|
<td headers="r1 r2 r7 c2 c3">35.3</td>
|
|
<td headers="r1 r2 r7 c2 c4">13.3</td>
|
|
<td headers="r1 r2 r7 c2 c5 c7">15.1</td>
|
|
<td headers="r1 r2 r7 c2 c5 c8">8.9</td>
|
|
<td headers="r1 r2 r7 c2 c6">44.0</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r8" headers="r1 r2 c1"></th>
|
|
<td headers="r1 r2 r7 r8 c2 c3">(0.5)</td>
|
|
<td headers="r1 r2 r7 r8 c2 c4">(0.7)</td>
|
|
<td headers="r1 r2 r7 r8 c2 c5 c7">(0.6)</td>
|
|
<td headers="r1 r2 r7 r8 c2 c5 c8">(1.3)</td>
|
|
<td headers="r1 r2 r7 r8 c2 c6">(1.1)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub2" id="r9" headers="r1 c1">Total</th>
|
|
<td headers="r1 r9 c2 c3">100.0</td>
|
|
<td headers="r1 r9 c2 c4">100.0</td>
|
|
<td headers="r1 r9 c2 c5 c7">100.0</td>
|
|
<td headers="r1 r9 c2 c5 c8">100.0</td>
|
|
<td headers="r1 r9 c2 c6">100.0</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r10" headers="r1 c1">Sex</th>
|
|
<td colspan="5"></td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r11" headers="r1 r10 c1">Women</th>
|
|
<td headers="r1 r10 r11 c2 c3">46.4</td>
|
|
<td headers="r1 r10 r11 c2 c4">61.8</td>
|
|
<td headers="r1 r10 r11 c2 c5 c7">44.5</td>
|
|
<td headers="r1 r10 r11 c2 c5 c8">55.9</td>
|
|
<td headers="r1 r10 r11 c2 c6">70.3</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r12" headers="r1 r10 c1"></th>
|
|
<td headers="r1 r10 r11 r12 c2 c3">(0.5)</td>
|
|
<td headers="r1 r10 r11 r12 c2 c4">(1.0)</td>
|
|
<td headers="r1 r10 r11 r12 c2 c5 c7">(0.8)</td>
|
|
<td headers="r1 r10 r11 r12 c2 c5 c8">(2.3)</td>
|
|
<td headers="r1 r10 r11 r12 c2 c6">(1.0)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r13" headers="r1 r10 c1">Men</th>
|
|
<td headers="r1 r10 r13 c2 c3">53.6</td>
|
|
<td headers="r1 r10 r13 c2 c4">38.2</td>
|
|
<td headers="r1 r10 r13 c2 c5 c7">55.5</td>
|
|
<td headers="r1 r10 r13 c2 c5 c8">44.1</td>
|
|
<td headers="r1 r10 r13 c2 c6">29.7</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r14" headers="r1 r10 c1"></th>
|
|
<td headers="r1 r10 r13 r14 c2 c3">(0.5)</td>
|
|
<td headers="r1 r10 r13 r14 c2 c4">(1.0)</td>
|
|
<td headers="r1 r10 r13 r14 c2 c5 c7">(0.8)</td>
|
|
<td headers="r1 r10 r13 r14 c2 c5 c8">(2.3)</td>
|
|
<td headers="r1 r10 r13 r14 c2 c6">(1.0)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub2" id="r15" headers="r1 c1">Total</th>
|
|
<td headers="r1 r15 c2 c3">100.0</td>
|
|
<td headers="r1 r15 c2 c4">100.0</td>
|
|
<td headers="r1 r15 c2 c5 c7">100.0</td>
|
|
<td headers="r1 r15 c2 c5 c8">100.0</td>
|
|
<td headers="r1 r15 c2 c6">100.0</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r16" headers="r1 c1">Race/ethnicity</th>
|
|
<td colspan="5"></td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r17" headers="r1 r16 c1">White, non-Hispanic</th>
|
|
<td headers="r1 r16 r17 c2 c3">85.3</td>
|
|
<td headers="r1 r16 r17 c2 c4">52.8</td>
|
|
<td headers="r1 r16 r17 c2 c5 c7">66.4</td>
|
|
<td headers="r1 r16 r17 c2 c5 c8">61.8</td>
|
|
<td headers="r1 r16 r17 c2 c6">77.7</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r18" headers="r1 r16 c1"></th>
|
|
<td headers="r1 r16 r17 r18 c2 c3">(0.4)</td>
|
|
<td headers="r1 r16 r17 r18 c2 c4">(1.1)</td>
|
|
<td headers="r1 r16 r17 r18 c2 c5 c7">(0.8)</td>
|
|
<td headers="r1 r16 r17 r18 c2 c5 c8">(2.3)</td>
|
|
<td headers="r1 r16 r17 r18 c2 c6">(0.9)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r19" headers="r1 r16 c1">Black, non-Hispanic</th>
|
|
<td headers="r1 r16 r19 c2 c3">6.3</td>
|
|
<td headers="r1 r16 r19 c2 c4">19.9</td>
|
|
<td headers="r1 r16 r19 c2 c5 c7">16.5</td>
|
|
<td headers="r1 r16 r19 c2 c5 c8">19.5</td>
|
|
<td headers="r1 r16 r19 c2 c6">6.7</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r20" headers="r1 r16 c1"></th>
|
|
<td headers="r1 r16 r19 r20 c2 c3">(0.3)</td>
|
|
<td headers="r1 r16 r19 r20 c2 c4">(0.9)</td>
|
|
<td headers="r1 r16 r19 r20 c2 c5 c7">(0.6)</td>
|
|
<td headers="r1 r16 r19 r20 c2 c5 c8">(1.8)</td>
|
|
<td headers="r1 r16 r19 r20 c2 c6">(0.6)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r21" headers="r1 r16 c1">Hispanic</th>
|
|
<td headers="r1 r16 r21 c2 c3">5.2</td>
|
|
<td headers="r1 r16 r21 c2 c4">20.1</td>
|
|
<td headers="r1 r16 r21 c2 c5 c7">13.7</td>
|
|
<td headers="r1 r16 r21 c2 c5 c8">13.8</td>
|
|
<td headers="r1 r16 r21 c2 c6">8.8</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r22" headers="r1 r16 c1"></th>
|
|
<td headers="r1 r16 r21 r22 c2 c3">(0.2)</td>
|
|
<td headers="r1 r16 r21 r22 c2 c4">(0.9)</td>
|
|
<td headers="r1 r16 r21 r22 c2 c5 c7">(0.6)</td>
|
|
<td headers="r1 r16 r21 r22 c2 c5 c8">(1.6)</td>
|
|
<td headers="r1 r16 r21 r22 c2 c6">(0.6)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r23" headers="r1 r16 c1">Other</th>
|
|
<td headers="r1 r16 r23 c2 c3">3.3</td>
|
|
<td headers="r1 r16 r23 c2 c4">7.2</td>
|
|
<td headers="r1 r16 r23 c2 c5 c7">3.4</td>
|
|
<td headers="r1 r16 r23 c2 c5 c8">4.9</td>
|
|
<td headers="r1 r16 r23 c2 c6">6.8</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r24" headers="r1 r16 c1"></th>
|
|
<td headers="r1 r16 r23 r24 c2 c3">(0.2)</td>
|
|
<td headers="r1 r16 r23 r24 c2 c4">(0.6)</td>
|
|
<td headers="r1 r16 r23 r24 c2 c5 c7">(0.3)</td>
|
|
<td headers="r1 r16 r23 r24 c2 c5 c8">(1.0)</td>
|
|
<td headers="r1 r16 r23 r24 c2 c6">(0.6)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub2" id="r25" headers="r1 c1">Total</th>
|
|
<td headers="r1 r25 c2 c3">100.0</td>
|
|
<td headers="r1 r25 c2 c4">100.0</td>
|
|
<td headers="r1 r25 c2 c5 c7">100.0</td>
|
|
<td headers="r1 r25 c2 c5 c8">100.0</td>
|
|
<td headers="r1 r25 c2 c6">100.0</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r26" headers="r1 c1">Marital status</th>
|
|
<td colspan="5"></td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r27" headers="r1 r26 c1">Married</th>
|
|
<td headers="r1 r26 r27 c2 c3">77.7</td>
|
|
<td headers="r1 r26 r27 c2 c4">28.0</td>
|
|
<td headers="r1 r26 r27 c2 c5 c7">31.9</td>
|
|
<td headers="r1 r26 r27 c2 c5 c8">15.0</td>
|
|
<td headers="r1 r26 r27 c2 c6">79.3</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r28" headers="r1 r26 c1"></th>
|
|
<td headers="r1 r26 r27 r28 c2 c3">(0.4)</td>
|
|
<td headers="r1 r26 r27 r28 c2 c4">(1.0)</td>
|
|
<td headers="r1 r26 r27 r28 c2 c5 c7">(0.8)</td>
|
|
<td headers="r1 r26 r27 r28 c2 c5 c8">(1.7)</td>
|
|
<td headers="r1 r26 r27 r28 c2 c6">(0.9)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r29" headers="r1 r26 c1">Widowed, divorced, or separated</th>
|
|
<td headers="r1 r26 r29 c2 c3">10.8</td>
|
|
<td headers="r1 r26 r29 c2 c4">15.5</td>
|
|
<td headers="r1 r26 r29 c2 c5 c7">25.2</td>
|
|
<td headers="r1 r26 r29 c2 c5 c8">14.5</td>
|
|
<td headers="r1 r26 r29 c2 c6">7.8</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r30" headers="r1 r26 c1"></th>
|
|
<td headers="r1 r26 r29 r30 c2 c3">(0.3)</td>
|
|
<td headers="r1 r26 r29 r30 c2 c4">(0.8)</td>
|
|
<td headers="r1 r26 r29 r30 c2 c5 c7">(0.7)</td>
|
|
<td headers="r1 r26 r29 r30 c2 c5 c8">(1.6)</td>
|
|
<td headers="r1 r26 r29 r30 c2 c6">(0.6)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r31" headers="r1 r26 c1">Never married</th>
|
|
<td headers="r1 r26 r31 c2 c3">11.5</td>
|
|
<td headers="r1 r26 r31 c2 c4">56.5</td>
|
|
<td headers="r1 r26 r31 c2 c5 c7">42.9</td>
|
|
<td headers="r1 r26 r31 c2 c5 c8">70.5</td>
|
|
<td headers="r1 r26 r31 c2 c6">13.0</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r32" headers="r1 r26 c1"></th>
|
|
<td headers="r1 r26 r31 r32 c2 c3">(0.3)</td>
|
|
<td headers="r1 r26 r31 r32 c2 c4">(1.1)</td>
|
|
<td headers="r1 r26 r31 r32 c2 c5 c7">(0.8)</td>
|
|
<td headers="r1 r26 r31 r32 c2 c5 c8">(2.1)</td>
|
|
<td headers="r1 r26 r31 r32 c2 c6">(0.8)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub2" id="r33" headers="r1 c1">Total</th>
|
|
<td headers="r1 r33 c2 c3">100.0</td>
|
|
<td headers="r1 r33 c2 c4">100.0</td>
|
|
<td headers="r1 r33 c2 c5 c7">100.0</td>
|
|
<td headers="r1 r33 c2 c5 c8">100.0</td>
|
|
<td headers="r1 r33 c2 c6">100.0</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r34" headers="r1 c1">Education</th>
|
|
<td colspan="5"></td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r35" headers="r1 r34 c1">Less than high school</th>
|
|
<td headers="r1 r34 r35 c2 c3">5.0</td>
|
|
<td headers="r1 r34 r35 c2 c4">30.1</td>
|
|
<td headers="r1 r34 r35 c2 c5 c7">14.2</td>
|
|
<td headers="r1 r34 r35 c2 c5 c8">19.7</td>
|
|
<td headers="r1 r34 r35 c2 c6">10.4</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r36" headers="r1 r34 c1"></th>
|
|
<td headers="r1 r34 r35 r36 c2 c3">(0.2)</td>
|
|
<td headers="r1 r34 r35 r36 c2 c4">(1.0)</td>
|
|
<td headers="r1 r34 r35 r36 c2 c5 c7">(0.6)</td>
|
|
<td headers="r1 r34 r35 r36 c2 c5 c8">(1.8)</td>
|
|
<td headers="r1 r34 r35 r36 c2 c6">(0.7)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r37" headers="r1 r34 c1">High school graduate</th>
|
|
<td headers="r1 r34 r37 c2 c3">28.6</td>
|
|
<td headers="r1 r34 r37 c2 c4">38.8</td>
|
|
<td headers="r1 r34 r37 c2 c5 c7">39.7</td>
|
|
<td headers="r1 r34 r37 c2 c5 c8">30.6</td>
|
|
<td headers="r1 r34 r37 c2 c6">30.3</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r38" headers="r1 r34 c1"></th>
|
|
<td headers="r1 r34 r37 r38 c2 c3">(0.5)</td>
|
|
<td headers="r1 r34 r37 r38 c2 c4">(1.0)</td>
|
|
<td headers="r1 r34 r37 r38 c2 c5 c7">(0.8)</td>
|
|
<td headers="r1 r34 r37 r38 c2 c5 c8">(2.1)</td>
|
|
<td headers="r1 r34 r37 r38 c2 c6">(1.0)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r39" headers="r1 r34 c1">More than high school</th>
|
|
<td headers="r1 r34 r39 c2 c3">66.4</td>
|
|
<td headers="r1 r34 r39 c2 c4">31.2</td>
|
|
<td headers="r1 r34 r39 c2 c5 c7">46.0</td>
|
|
<td headers="r1 r34 r39 c2 c5 c8">49.6</td>
|
|
<td headers="r1 r34 r39 c2 c6">59.3</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r40" headers="r1 r34 c1"></th>
|
|
<td headers="r1 r34 r39 r40 c2 c3">(0.5)</td>
|
|
<td headers="r1 r34 r39 r40 c2 c4">(1.0)</td>
|
|
<td headers="r1 r34 r39 r40 c2 c5 c7">(0.8)</td>
|
|
<td headers="r1 r34 r39 r40 c2 c5 c8">(2.3)</td>
|
|
<td headers="r1 r34 r39 r40 c2 c6">(1.1)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub2" id="r41" headers="r1 c1">Total percent</th>
|
|
<td headers="r1 r41 c2 c3">100.0</td>
|
|
<td headers="r1 r41 c2 c4">100.0</td>
|
|
<td headers="r1 r41 c2 c5 c7">100.0</td>
|
|
<td headers="r1 r41 c2 c5 c8">100.0</td>
|
|
<td headers="r1 r41 c2 c6">100.0</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r42" headers="r1 c1">Presence of child under age 18</th>
|
|
<td colspan="5"></td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r43" headers="r1 r42 c1">Yes</th>
|
|
<td headers="r1 r42 r43 c2 c3">44.8</td>
|
|
<td headers="r1 r42 r43 c2 c4">51.6</td>
|
|
<td headers="r1 r42 r43 c2 c5 c7">41.4</td>
|
|
<td headers="r1 r42 r43 c2 c5 c8">42.1</td>
|
|
<td headers="r1 r42 r43 c2 c6">46.6</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r44" headers="r1 r42 c1"></th>
|
|
<td headers="r1 r42 r43 r44 c2 c3">(0.5)</td>
|
|
<td headers="r1 r42 r43 r44 c2 c4">(1.1)</td>
|
|
<td headers="r1 r42 r43 r44 c2 c5 c7">(0.8)</td>
|
|
<td headers="r1 r42 r43 r44 c2 c5 c8">(2.3)</td>
|
|
<td headers="r1 r42 r43 r44 c2 c6">(1.1)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r45" headers="r1 r42 c1">No</th>
|
|
<td headers="r1 r42 r45 c2 c3">55.2</td>
|
|
<td headers="r1 r42 r45 c2 c4">48.5</td>
|
|
<td headers="r1 r42 r45 c2 c5 c7">58.6</td>
|
|
<td headers="r1 r42 r45 c2 c5 c8">57.9</td>
|
|
<td headers="r1 r42 r45 c2 c6">53.4</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r46" headers="r1 r42 c1"></th>
|
|
<td headers="r1 r42 r45 r46 c2 c3">(0.5)</td>
|
|
<td headers="r1 r42 r45 r46 c2 c4">(1.1)</td>
|
|
<td headers="r1 r42 r45 r46 c2 c5 c7">(0.8)</td>
|
|
<td headers="r1 r42 r45 r46 c2 c5 c8">(2.3)</td>
|
|
<td headers="r1 r42 r45 r46 c2 c6">(1.1)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub2" id="r47" headers="r1 c1">Total</th>
|
|
<td headers="r1 r47 c2 c3">100.0</td>
|
|
<td headers="r1 r47 c2 c4">100.0</td>
|
|
<td headers="r1 r47 c2 c5 c7">100.0</td>
|
|
<td headers="r1 r47 c2 c5 c8">100.0</td>
|
|
<td headers="r1 r47 c2 c6">100.0</td>
|
|
</tr>
|
|
<tr class="shaded">
|
|
<th class="stub3" id="r48" headers="r1 c1">Total number <sup>c</sup></th>
|
|
<td headers="r1 r48 c2 c3">21,331</td>
|
|
<td headers="r1 r48 c2 c4">5,117</td>
|
|
<td headers="r1 r48 c2 c5 c7">8,953</td>
|
|
<td headers="r1 r48 c2 c5 c8">1,089</td>
|
|
<td headers="r1 r48 c2 c6">4,586</td>
|
|
</tr>
|
|
</tbody>
|
|
<tfoot>
|
|
<tr>
|
|
<td class="firstNote" colspan="6">SOURCE: Survey of Income and Program Participation (<abbr>SIPP</abbr>) matched to Social Security Administration (<abbr class="spell">SSA</abbr>) administrative records, November 1996.</td>
|
|
</tr>
|
|
<tr>
|
|
<td class="note" colspan="6">NOTES: The universe for Tables 2 through 6 includes only current nonparticipants; current <abbr class="spell">SSI</abbr> or <abbr class="spell">DI</abbr> participants are excluded from the tabulations.</td>
|
|
</tr>
|
|
<tr>
|
|
<td class="note" colspan="6"><abbr class="spell">DI</abbr> = Disability Insurance; <abbr class="spell">SSI</abbr> = Supplemental Security Income.</td>
|
|
</tr>
|
|
<tr>
|
|
<td class="note" colspan="6">a. In the calculation of <abbr class="spell">SSI</abbr> financial eligibility, own earnings was adjusted to account for the substantial gainful activity ceiling of the <abbr class="spell">SSA</abbr> categorical eligibility screen.</td>
|
|
</tr>
|
|
<tr>
|
|
<td class="note" colspan="6">b. Weighted. Estimated standard errors in parentheses. The standard error estimates assume a design effect of 2.34 to account for the complex <abbr>SIPP</abbr> sample design (see Census Bureau, 2001, Table 4, <abbr title="page">p.</abbr> 22).</td>
|
|
</tr>
|
|
<tr>
|
|
<td class="lastNote" colspan="6">c. Unweighted number of sample observations.</td>
|
|
</tr>
|
|
</tfoot>
|
|
</table>
|
|
</div>
|
|
<p>Thus it is not surprising that there is a clear contrast between the two groups that are covered only by one of the two programs. Compared with the group covered by <abbr class="spell">DI</abbr> alone, those covered only by <abbr class="spell">SSI</abbr> often are younger, women, nonwhite, unmarried, have less education, and no minor children. All of the relevant subgroup comparisons indicate differences that are statistically significant, and most of them are large. Most of the characteristics listed above are historically associated with relatively low-earning potential (Sohota 1978).</p>
|
|
<p>Next we look at the two groups of concurrent eligibles. As expected, all <abbr class="spell">SSI</abbr>-covered groups tend to be relatively young compared with the <abbr class="spell">DI</abbr>-only group. Members of the two subgroups of concurrent nonparticipants in most cases have other characteristics that are in-between the <abbr class="spell">DI</abbr>-only and <abbr class="spell">SSI</abbr>-only groups. Also as expected, <i>joint</i> eligibles are often closer to <abbr class="spell">SSI</abbr>-only than are <i>serial</i> eligibles. They tend to be even younger than the <abbr class="spell">SSI</abbr>-only group.</p>
|
|
<p>An important and interesting group is the one not covered by either the <abbr class="spell">DI</abbr> or <abbr class="spell">SSI</abbr> programs. The noncovered group has the highest proportion of women among all of the groups, and—consistent with the findings of Mitchell and Phillips (2001) concerning the decline of <abbr class="spell">DI</abbr>-insured status among the near elderly—the highest proportion of nonparticipants in the oldest (aged <span class="nobr">46–64</span>) age group category. However, the noncovered group is fairly similar to the <abbr class="spell">DI</abbr>-only group on all other demographic measures. This suggests that an important subset of the noncovered group may include relatively old, predominantly white (non-Hispanic) women with relatively weak labor force attachment who are married to spouses whose earnings and assets may disqualify them from potential <abbr class="spell">SSI</abbr> financial eligibility. In effect, family resources may provide a nontrivial cushion for these people in the event of potential disablement. The data are also consistent with the hypothesis that others may be economically vulnerable for some of the same reasons that Mitchell and Phillips suggest. Older men and women who lose <abbr class="spell">DI</abbr>-insured status may have income and resources that marginally disqualify them from potential <abbr class="spell">SSI</abbr> financial eligibility. All in all, there may be substantial heterogeneity within the category of those who appear unprotected by the <abbr class="spell">DI</abbr> and/or <abbr class="spell">SSI</abbr> public cash benefit safety nets in terms of economic vulnerability. In the analyses below we present additional evidence that is directly relevant for the assessment of this internal heterogeneity.</p>
|
|
<p>Table 3 provides data on several health, disability, and mortality indicators. The overwhelming impression here is that current nonparticipants tend to have "excellent" or "very good" current health status, and low prevalence of individual disabling conditions and mortality risk (measured by mortality status 4 and 10 years after the survey reference month). There is a striking, but not surprising, contrast between findings from the literature on the health, disability, and mortality risk of <i>current</i> disability beneficiaries.<sup><a href="#mn24" id="mt24">24</a></sup> Note, however, that the numbers in Table 3 represent population averages for a wide cross-section of the working-age—most of which shows no current sign of serious health problems or disabling conditions, in contrast to a highly select group of beneficiaries defined on the basis of meeting a stringent disability test.</p>
|
|
<div class="table" id="table3">
|
|
<table>
|
|
<caption><span class="tableNumber">Table 3. </span>Health, disabilities, and subsequent mortality experience of <abbr class="spell">DI</abbr> and <abbr class="spell">SSI</abbr> nonparticipants aged <span class="nobr">18–64</span>, by potential access to <abbr class="spell">DI</abbr> and/or <abbr class="spell">SSI</abbr></caption>
|
|
<colgroup span="1" style="width:25em"></colgroup>
|
|
<colgroup span="5" style="width:8em"></colgroup>
|
|
<thead>
|
|
<tr>
|
|
<th class="stubHeading" rowspan="3" id="c1">Characteristic</th>
|
|
<th class="spanner" colspan="5" id="c2">Current nonparticipants by potential access to <abbr class="spell">DI</abbr> and/or <abbr class="spell">SSI</abbr> <sup>a</sup></th>
|
|
</tr>
|
|
<tr>
|
|
<th rowspan="2" id="c3" headers="c2"><abbr class="spell">DI</abbr>-insured<br>only</th>
|
|
<th rowspan="2" id="c4" headers="c2"><abbr class="spell">SSI</abbr>-eligible<br>only</th>
|
|
<th class="spanner" colspan="2" id="c5" headers="c2">Concurrent <abbr class="spell">DI</abbr>/<abbr class="spell">SSI</abbr> eligibles</th>
|
|
<th rowspan="2" id="c6" headers="c2">Neither <abbr class="spell">DI</abbr><br>insured nor<br><abbr class="spell">SSI</abbr> eligible</th>
|
|
</tr>
|
|
<tr>
|
|
<th id="c7" headers="c2 c5">Serial <abbr class="spell">SSI</abbr><br>to <abbr class="spell">DI</abbr></th>
|
|
<th id="c8" headers="c2 c5">Joint <abbr class="spell">SSI</abbr><br>and <abbr class="spell">DI</abbr></th>
|
|
</tr>
|
|
</thead>
|
|
<tbody>
|
|
<tr>
|
|
<td></td>
|
|
<th class="panel" colspan="5" id="r1">Percentage distribution <sup>b</sup></th>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r2" headers="r1 c1">Reported health status (reference month)</th>
|
|
<td colspan="5"></td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r3" headers="r1 r2 c1">Excellent</th>
|
|
<td headers="r1 r2 r3 c2 c3">35.7</td>
|
|
<td headers="r1 r2 r3 c2 c4">31.1</td>
|
|
<td headers="r1 r2 r3 c2 c5 c7">31.0</td>
|
|
<td headers="r1 r2 r3 c2 c5 c8">36.5</td>
|
|
<td headers="r1 r2 r3 c2 c6">31.6</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r4" headers="r1 r2 c1"></th>
|
|
<td headers="r1 r2 r3 r4 c2 c3">(0.5)</td>
|
|
<td headers="r1 r2 r3 r4 c2 c4">(1.0)</td>
|
|
<td headers="r1 r2 r3 r4 c2 c5 c7">(0.7)</td>
|
|
<td headers="r1 r2 r3 r4 c2 c5 c8">(2.2)</td>
|
|
<td headers="r1 r2 r3 r4 c2 c6">(1.0)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r5" headers="r1 r2 c1">Very good</th>
|
|
<td headers="r1 r2 r5 c2 c3">36.9</td>
|
|
<td headers="r1 r2 r5 c2 c4">29.8</td>
|
|
<td headers="r1 r2 r5 c2 c5 c7">34.4</td>
|
|
<td headers="r1 r2 r5 c2 c5 c8">30.2</td>
|
|
<td headers="r1 r2 r5 c2 c6">32.8</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r6" headers="r1 r2 c1"></th>
|
|
<td headers="r1 r2 r5 r6 c2 c3">(0.5)</td>
|
|
<td headers="r1 r2 r5 r6 c2 c4">(1.0)</td>
|
|
<td headers="r1 r2 r5 r6 c2 c5 c7">(0.8)</td>
|
|
<td headers="r1 r2 r5 r6 c2 c5 c8">(2.1)</td>
|
|
<td headers="r1 r2 r5 r6 c2 c6">(1.1)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r7" headers="r1 r2 c1">Good</th>
|
|
<td headers="r1 r2 r7 c2 c3">21.7</td>
|
|
<td headers="r1 r2 r7 c2 c4">26.0</td>
|
|
<td headers="r1 r2 r7 c2 c5 c7">26.0</td>
|
|
<td headers="r1 r2 r7 c2 c5 c8">20.8</td>
|
|
<td headers="r1 r2 r7 c2 c6">23.6</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r8" headers="r1 r2 c1"></th>
|
|
<td headers="r1 r2 r7 r8 c2 c3">(0.4)</td>
|
|
<td headers="r1 r2 r7 r8 c2 c4">(0.9)</td>
|
|
<td headers="r1 r2 r7 r8 c2 c5 c7">(0.7)</td>
|
|
<td headers="r1 r2 r7 r8 c2 c5 c8">(1.9)</td>
|
|
<td headers="r1 r2 r7 r8 c2 c6">(1.0)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r9" headers="r1 r2 c1">Fair</th>
|
|
<td headers="r1 r2 r9 c2 c3">4.9</td>
|
|
<td headers="r1 r2 r9 c2 c4">9.5</td>
|
|
<td headers="r1 r2 r9 c2 c5 c7">7.2</td>
|
|
<td headers="r1 r2 r9 c2 c5 c8">8.9</td>
|
|
<td headers="r1 r2 r9 c2 c6">8.8</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r10" headers="r1 r2 c1"></th>
|
|
<td headers="r1 r2 r9 r10 c2 c3">(0.2)</td>
|
|
<td headers="r1 r2 r9 r10 c2 c4">(0.6)</td>
|
|
<td headers="r1 r2 r9 r10 c2 c5 c7">(0.4)</td>
|
|
<td headers="r1 r2 r9 r10 c2 c5 c8">(1.3)</td>
|
|
<td headers="r1 r2 r9 r10 c2 c6">(0.6)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r11" headers="r1 r2 c1">Poor</th>
|
|
<td headers="r1 r2 r11 c2 c3">0.9</td>
|
|
<td headers="r1 r2 r11 c2 c4">3.6</td>
|
|
<td headers="r1 r2 r11 c2 c5 c7">1.4</td>
|
|
<td headers="r1 r2 r11 c2 c5 c8">3.6</td>
|
|
<td headers="r1 r2 r11 c2 c6">3.2</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r12" headers="r1 r2 c1"></th>
|
|
<td headers="r1 r2 r11 r12 c2 c3">(0.1)</td>
|
|
<td headers="r1 r2 r11 r12 c2 c4">(0.4)</td>
|
|
<td headers="r1 r2 r11 r12 c2 c5 c7">(0.2)</td>
|
|
<td headers="r1 r2 r11 r12 c2 c5 c8">(0.9)</td>
|
|
<td headers="r1 r2 r11 r12 c2 c6">(0.4)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub2" id="r13" headers="r1 r2 r12 c1">Total</th>
|
|
<td headers="r1 r2 r12 r13 c2 c3">100.0</td>
|
|
<td headers="r1 r2 r12 r13 c2 c4">100.0</td>
|
|
<td headers="r1 r2 r12 r13 c2 c5 c7">100.0</td>
|
|
<td headers="r1 r2 r12 r13 c2 c5 c8">100.0</td>
|
|
<td headers="r1 r2 r12 r13 c2 c6">100.0</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r14" headers="r1 c1">Work-limiting condition, reported in two waves</th>
|
|
<td colspan="5"></td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r15" headers="r1 r14 c1">Yes</th>
|
|
<td headers="r1 r14 r15 c2 c3">2.1</td>
|
|
<td headers="r1 r14 r15 c2 c4">5.3</td>
|
|
<td headers="r1 r14 r15 c2 c5 c7">2.3</td>
|
|
<td headers="r1 r14 r15 c2 c5 c8">5.6</td>
|
|
<td headers="r1 r14 r15 c2 c6">6.4</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r16" headers="r1 r14 c1"></th>
|
|
<td headers="r1 r14 r15 r16 c2 c3">(0.2)</td>
|
|
<td headers="r1 r14 r15 r16 c2 c4">(0.5)</td>
|
|
<td headers="r1 r14 r15 r16 c2 c5 c7">(0.2)</td>
|
|
<td headers="r1 r14 r15 r16 c2 c5 c8">(1.1)</td>
|
|
<td headers="r1 r14 r15 r16 c2 c6">(0.6)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r17" headers="r1 r14 c1">No</th>
|
|
<td headers="r1 r14 r17 c2 c3">97.9</td>
|
|
<td headers="r1 r14 r17 c2 c4">94.7</td>
|
|
<td headers="r1 r14 r17 c2 c5 c7">97.7</td>
|
|
<td headers="r1 r14 r17 c2 c5 c8">94.4</td>
|
|
<td headers="r1 r14 r17 c2 c6">93.6</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r18" headers="r1 r14 c1"></th>
|
|
<td headers="r1 r14 r17 r18 c2 c3">(0.2)</td>
|
|
<td headers="r1 r14 r17 r18 c2 c4">(0.5)</td>
|
|
<td headers="r1 r14 r17 r18 c2 c5 c7">(0.2)</td>
|
|
<td headers="r1 r14 r17 r18 c2 c5 c8">(1.1)</td>
|
|
<td headers="r1 r14 r17 r18 c2 c6">(0.6)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub2" id="r19" headers="r1 r14 r18 c1">Total</th>
|
|
<td headers="r1 r14 r18 r19 c2 c3">100.0</td>
|
|
<td headers="r1 r14 r18 r19 c2 c4">100.0</td>
|
|
<td headers="r1 r14 r18 r19 c2 c5 c7">100.0</td>
|
|
<td headers="r1 r14 r18 r19 c2 c5 c8">100.0</td>
|
|
<td headers="r1 r14 r18 r19 c2 c6">100.0</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r20" headers="r1 c1">Work-preventing condition, reported in two waves</th>
|
|
<td colspan="5"></td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r21" headers="r1 r20 c1">Yes</th>
|
|
<td headers="r1 r20 r21 c2 c3">0.4</td>
|
|
<td headers="r1 r20 r21 c2 c4">3.1</td>
|
|
<td headers="r1 r20 r21 c2 c5 c7">0.7</td>
|
|
<td headers="r1 r20 r21 c2 c5 c8">2.9</td>
|
|
<td headers="r1 r20 r21 c2 c6">3.5</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r22" headers="r1 r20 c1"></th>
|
|
<td headers="r1 r20 r21 r22 c2 c3">(0.1)</td>
|
|
<td headers="r1 r20 r21 r22 c2 c4">(0.4)</td>
|
|
<td headers="r1 r20 r21 r22 c2 c5 c7">(0.1)</td>
|
|
<td headers="r1 r20 r21 r22 c2 c5 c8">(0.8)</td>
|
|
<td headers="r1 r20 r21 r22 c2 c6">(0.4)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r23" headers="r1 r20 c1">No</th>
|
|
<td headers="r1 r20 r23 c2 c3">99.6</td>
|
|
<td headers="r1 r20 r23 c2 c4">96.9</td>
|
|
<td headers="r1 r20 r23 c2 c5 c7">99.3</td>
|
|
<td headers="r1 r20 r23 c2 c5 c8">97.1</td>
|
|
<td headers="r1 r20 r23 c2 c6">96.5</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r24" headers="r1 r20 c1"></th>
|
|
<td headers="r1 r20 r23 r24 c2 c3">(0.1)</td>
|
|
<td headers="r1 r20 r23 r24 c2 c4">(0.4)</td>
|
|
<td headers="r1 r20 r23 r24 c2 c5 c7">(0.1)</td>
|
|
<td headers="r1 r20 r23 r24 c2 c5 c8">(0.8)</td>
|
|
<td headers="r1 r20 r23 r24 c2 c6">(0.4)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub2" id="r25" headers="r1 r20 r24 c1">Total</th>
|
|
<td headers="r1 r20 r24 r25 c2 c3">100.0</td>
|
|
<td headers="r1 r20 r24 r25 c2 c4">100.0</td>
|
|
<td headers="r1 r20 r24 r25 c2 c5 c7">100.0</td>
|
|
<td headers="r1 r20 r24 r25 c2 c5 c8">100.0</td>
|
|
<td headers="r1 r20 r24 r25 c2 c6">100.0</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r26" headers="r1 c1">Number of reported <abbr class="spell">ADL</abbr> limitations (reference month)</th>
|
|
<td colspan="5"></td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r27" headers="r1 r26 c1">None</th>
|
|
<td headers="r1 r26 r27 c2 c3">99.7</td>
|
|
<td headers="r1 r26 r27 c2 c4">99.4</td>
|
|
<td headers="r1 r26 r27 c2 c5 c7">99.7</td>
|
|
<td headers="r1 r26 r27 c2 c5 c8">99.4</td>
|
|
<td headers="r1 r26 r27 c2 c6">99.1</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r28" headers="r1 r26 c1"></th>
|
|
<td headers="r1 r26 r27 r28 c2 c3">(0.1)</td>
|
|
<td headers="r1 r26 r27 r28 c2 c4">(0.2)</td>
|
|
<td headers="r1 r26 r27 r28 c2 c5 c7">(0.1)</td>
|
|
<td headers="r1 r26 r27 r28 c2 c5 c8">(0.3)</td>
|
|
<td headers="r1 r26 r27 r28 c2 c6">(0.2)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r29" headers="r1 r26 c1">One</th>
|
|
<td headers="r1 r26 r29 c2 c3">0.1</td>
|
|
<td headers="r1 r26 r29 c2 c4">0.2</td>
|
|
<td headers="r1 r26 r29 c2 c5 c7">0.2</td>
|
|
<td headers="r1 r26 r29 c2 c5 c8">0.3</td>
|
|
<td headers="r1 r26 r29 c2 c6">0.4</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r30" headers="r1 r26 c1"></th>
|
|
<td headers="r1 r26 r29 r30 c2 c3">(0.0)</td>
|
|
<td headers="r1 r26 r29 r30 c2 c4">(0.1)</td>
|
|
<td headers="r1 r26 r29 r30 c2 c5 c7">(0.1)</td>
|
|
<td headers="r1 r26 r29 r30 c2 c5 c8">(0.2)</td>
|
|
<td headers="r1 r26 r29 r30 c2 c6">(0.1)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r31" headers="r1 r26 c1">Two or more</th>
|
|
<td headers="r1 r26 r31 c2 c3">0.2</td>
|
|
<td headers="r1 r26 r31 c2 c4">0.4</td>
|
|
<td headers="r1 r26 r31 c2 c5 c7">0.1</td>
|
|
<td headers="r1 r26 r31 c2 c5 c8">0.3</td>
|
|
<td headers="r1 r26 r31 c2 c6">0.6</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r32" headers="r1 r26 c1"></th>
|
|
<td headers="r1 r26 r31 r32 c2 c3">(0.0)</td>
|
|
<td headers="r1 r26 r31 r32 c2 c4">(0.1)</td>
|
|
<td headers="r1 r26 r31 r32 c2 c5 c7">(0.1)</td>
|
|
<td headers="r1 r26 r31 r32 c2 c5 c8">(0.3)</td>
|
|
<td headers="r1 r26 r31 r32 c2 c6">(0.2)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub2" id="r33" headers="r1 r26 r32 c1">Total</th>
|
|
<td headers="r1 r26 r32 r33 c2 c3">100.0</td>
|
|
<td headers="r1 r26 r32 r33 c2 c4">100.0</td>
|
|
<td headers="r1 r26 r32 r33 c2 c5 c7">100.0</td>
|
|
<td headers="r1 r26 r32 r33 c2 c5 c8">100.0</td>
|
|
<td headers="r1 r26 r32 r33 c2 c6">100.0</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r34" headers="r1 c1">Number of reported <abbr class="spell">IADL</abbr> limitations (reference month)</th>
|
|
<td colspan="5"></td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r35" headers="r1 r34 c1">None</th>
|
|
<td headers="r1 r34 r35 c2 c3">99.3</td>
|
|
<td headers="r1 r34 r35 c2 c4">98.2</td>
|
|
<td headers="r1 r34 r35 c2 c5 c7">99.4</td>
|
|
<td headers="r1 r34 r35 c2 c5 c8">98.6</td>
|
|
<td headers="r1 r34 r35 c2 c6">98.0</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r36" headers="r1 r34 c1"></th>
|
|
<td headers="r1 r34 r35 r36 c2 c3">(0.1)</td>
|
|
<td headers="r1 r34 r35 r36 c2 c4">(0.3)</td>
|
|
<td headers="r1 r34 r35 r36 c2 c5 c7">(0.1)</td>
|
|
<td headers="r1 r34 r35 r36 c2 c5 c8">(0.5)</td>
|
|
<td headers="r1 r34 r35 r36 c2 c6">(0.3)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r37" headers="r1 r34 c1">One</th>
|
|
<td headers="r1 r34 r37 c2 c3">0.4</td>
|
|
<td headers="r1 r34 r37 c2 c4">1.0</td>
|
|
<td headers="r1 r34 r37 c2 c5 c7">0.4</td>
|
|
<td headers="r1 r34 r37 c2 c5 c8">0.7</td>
|
|
<td headers="r1 r34 r37 c2 c6">1.1</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r38" headers="r1 r34 c1"></th>
|
|
<td headers="r1 r34 r37 r38 c2 c3">(0.1)</td>
|
|
<td headers="r1 r34 r37 r38 c2 c4">(0.2)</td>
|
|
<td headers="r1 r34 r37 r38 c2 c5 c7">(0.1)</td>
|
|
<td headers="r1 r34 r37 r38 c2 c5 c8">(0.4)</td>
|
|
<td headers="r1 r34 r37 r38 c2 c6">(0.2)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r39" headers="r1 r34 c1">Two or more</th>
|
|
<td headers="r1 r34 r39 c2 c3">0.3</td>
|
|
<td headers="r1 r34 r39 c2 c4">0.8</td>
|
|
<td headers="r1 r34 r39 c2 c5 c7">0.2</td>
|
|
<td headers="r1 r34 r39 c2 c5 c8">0.7</td>
|
|
<td headers="r1 r34 r39 c2 c6">0.9</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r40" headers="r1 r34 c1"></th>
|
|
<td headers="r1 r34 r39 r40 c2 c3">(0.1)</td>
|
|
<td headers="r1 r34 r39 r40 c2 c4">(0.2)</td>
|
|
<td headers="r1 r34 r39 r40 c2 c5 c7">(0.1)</td>
|
|
<td headers="r1 r34 r39 r40 c2 c5 c8">(0.4)</td>
|
|
<td headers="r1 r34 r39 r40 c2 c6">(0.2)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub2" id="r41" headers="r1 r34 r40 c1">Total</th>
|
|
<td headers="r1 r34 r40 r41 c2 c3">100.0</td>
|
|
<td headers="r1 r34 r40 r41 c2 c4">100.0</td>
|
|
<td headers="r1 r34 r40 r41 c2 c5 c7">100.0</td>
|
|
<td headers="r1 r34 r40 r41 c2 c5 c8">100.0</td>
|
|
<td headers="r1 r34 r40 r41 c2 c6">100.0</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r42" headers="r1 c1">Number of hospitalizations during previous 12 months</th>
|
|
<td colspan="5"></td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r43" headers="r1 r42 c1">None</th>
|
|
<td headers="r1 r42 r43 c2 c3">93.0</td>
|
|
<td headers="r1 r42 r43 c2 c4">91.6</td>
|
|
<td headers="r1 r42 r43 c2 c5 c7">93.0</td>
|
|
<td headers="r1 r42 r43 c2 c5 c8">89.2</td>
|
|
<td headers="r1 r42 r43 c2 c6">91.8</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r44" headers="r1 r42 c1"></th>
|
|
<td headers="r1 r42 r43 r44 c2 c3">(0.3)</td>
|
|
<td headers="r1 r42 r43 r44 c2 c4">(0.6)</td>
|
|
<td headers="r1 r42 r43 r44 c2 c5 c7">(0.4)</td>
|
|
<td headers="r1 r42 r43 r44 c2 c5 c8">(1.4)</td>
|
|
<td headers="r1 r42 r43 r44 c2 c6">(0.6)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r45" headers="r1 r42 c1">One to five</th>
|
|
<td headers="r1 r42 r45 c2 c3">5.5</td>
|
|
<td headers="r1 r42 r45 c2 c4">6.1</td>
|
|
<td headers="r1 r42 r45 c2 c5 c7">5.5</td>
|
|
<td headers="r1 r42 r45 c2 c5 c8">8.3</td>
|
|
<td headers="r1 r42 r45 c2 c6">6.2</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r46" headers="r1 r42 c1"></th>
|
|
<td headers="r1 r42 r45 r46 c2 c3">(0.2)</td>
|
|
<td headers="r1 r42 r45 r46 c2 c4">(0.5)</td>
|
|
<td headers="r1 r42 r45 r46 c2 c5 c7">(0.4)</td>
|
|
<td headers="r1 r42 r45 r46 c2 c5 c8">(1.3)</td>
|
|
<td headers="r1 r42 r45 r46 c2 c6">(0.5)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r47" headers="r1 r42 c1">More than five</th>
|
|
<td headers="r1 r42 r47 c2 c3">1.4</td>
|
|
<td headers="r1 r42 r47 c2 c4">2.3</td>
|
|
<td headers="r1 r42 r47 c2 c5 c7">1.5</td>
|
|
<td headers="r1 r42 r47 c2 c5 c8">2.5</td>
|
|
<td headers="r1 r42 r47 c2 c6">2.0</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r48" headers="r1 r42 c1"></th>
|
|
<td headers="r1 r42 r47 r48 c2 c3">(0.1)</td>
|
|
<td headers="r1 r42 r47 r48 c2 c4">(0.3)</td>
|
|
<td headers="r1 r42 r47 r48 c2 c5 c7">(0.2)</td>
|
|
<td headers="r1 r42 r47 r48 c2 c5 c8">(0.7)</td>
|
|
<td headers="r1 r42 r47 r48 c2 c6">(0.3)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub2" id="r49" headers="r1 r42 r48 c1">Total</th>
|
|
<td headers="r1 r42 r48 r49 c2 c3">100.0</td>
|
|
<td headers="r1 r42 r48 r49 c2 c4">100.0</td>
|
|
<td headers="r1 r42 r48 r49 c2 c5 c7">100.0</td>
|
|
<td headers="r1 r42 r48 r49 c2 c5 c8">100.0</td>
|
|
<td headers="r1 r42 r48 r49 c2 c6">100.0</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r50" headers="r1 c1">Number of doctor visits during previous 12 months</th>
|
|
<td colspan="5"></td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r51" headers="r1 r50 c1">None</th>
|
|
<td headers="r1 r50 r51 c2 c3">21.6</td>
|
|
<td headers="r1 r50 r51 c2 c4">36.1</td>
|
|
<td headers="r1 r50 r51 c2 c5 c7">34.8</td>
|
|
<td headers="r1 r50 r51 c2 c5 c8">30.7</td>
|
|
<td headers="r1 r50 r51 c2 c6">19.6</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r52" headers="r1 r50 c1"></th>
|
|
<td headers="r1 r50 r51 r52 c2 c3">(0.4)</td>
|
|
<td headers="r1 r50 r51 r52 c2 c4">(1.0)</td>
|
|
<td headers="r1 r50 r51 r52 c2 c5 c7">(0.8)</td>
|
|
<td headers="r1 r50 r51 r52 c2 c5 c8">(2.1)</td>
|
|
<td headers="r1 r50 r51 r52 c2 c6">(0.9)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r53" headers="r1 r50 c1">One to ten</th>
|
|
<td headers="r1 r50 r53 c2 c3">69.6</td>
|
|
<td headers="r1 r50 r53 c2 c4">55.1</td>
|
|
<td headers="r1 r50 r53 c2 c5 c7">58.0</td>
|
|
<td headers="r1 r50 r53 c2 c5 c8">60.4</td>
|
|
<td headers="r1 r50 r53 c2 c6">69.2</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r54" headers="r1 r50 c1"></th>
|
|
<td headers="r1 r50 r53 r54 c2 c3">(0.5)</td>
|
|
<td headers="r1 r50 r53 r54 c2 c4">(1.1)</td>
|
|
<td headers="r1 r50 r53 r54 c2 c5 c7">(0.8)</td>
|
|
<td headers="r1 r50 r53 r54 c2 c5 c8">(2.3)</td>
|
|
<td headers="r1 r50 r53 r54 c2 c6">(1.0)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r55" headers="r1 r50 c1">More than ten</th>
|
|
<td headers="r1 r50 r55 c2 c3">8.9</td>
|
|
<td headers="r1 r50 r55 c2 c4">8.9</td>
|
|
<td headers="r1 r50 r55 c2 c5 c7">7.2</td>
|
|
<td headers="r1 r50 r55 c2 c5 c8">8.9</td>
|
|
<td headers="r1 r50 r55 c2 c6">11.2</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r56" headers="r1 r50 c1"></th>
|
|
<td headers="r1 r50 r55 r56 c2 c3">(0.3)</td>
|
|
<td headers="r1 r50 r55 r56 c2 c4">(0.6)</td>
|
|
<td headers="r1 r50 r55 r56 c2 c5 c7">(0.4)</td>
|
|
<td headers="r1 r50 r55 r56 c2 c5 c8">(1.3)</td>
|
|
<td headers="r1 r50 r55 r56 c2 c6">(0.7)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub2" id="r57" headers="r1 r50 r56 c1">Total</th>
|
|
<td headers="r1 r50 r56 r57 c2 c3">100.0</td>
|
|
<td headers="r1 r50 r56 r57 c2 c4">100.0</td>
|
|
<td headers="r1 r50 r56 r57 c2 c5 c7">100.0</td>
|
|
<td headers="r1 r50 r56 r57 c2 c5 c8">100.0</td>
|
|
<td headers="r1 r50 r56 r57 c2 c6">100.0</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r58" headers="r1 c1">Number of disability indicators <sup>c</sup></th>
|
|
<td colspan="5"></td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r59" headers="r1 r58 c1">None</th>
|
|
<td headers="r1 r58 r59 c2 c3">81.2</td>
|
|
<td headers="r1 r58 r59 c2 c4">75.3</td>
|
|
<td headers="r1 r58 r59 c2 c5 c7">81.1</td>
|
|
<td headers="r1 r58 r59 c2 c5 c8">74.4</td>
|
|
<td headers="r1 r58 r59 c2 c6">73.8</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r60" headers="r1 r58 c1"></th>
|
|
<td headers="r1 r58 r59 r60 c2 c3">(0.4)</td>
|
|
<td headers="r1 r58 r59 r60 c2 c4">(0.9)</td>
|
|
<td headers="r1 r58 r59 r60 c2 c5 c7">(0.6)</td>
|
|
<td headers="r1 r58 r59 r60 c2 c5 c8">(2.0)</td>
|
|
<td headers="r1 r58 r59 r60 c2 c6">(1.0)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r61" headers="r1 r58 c1">One of five</th>
|
|
<td headers="r1 r58 r61 c2 c3">12.8</td>
|
|
<td headers="r1 r58 r61 c2 c4">14.9</td>
|
|
<td headers="r1 r58 r61 c2 c5 c7">12.7</td>
|
|
<td headers="r1 r58 r61 c2 c5 c8">14.4</td>
|
|
<td headers="r1 r58 r61 c2 c6">15.4</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r62" headers="r1 r58 c1"></th>
|
|
<td headers="r1 r58 r61 r62 c2 c3">(0.3)</td>
|
|
<td headers="r1 r58 r61 r62 c2 c4">(0.8)</td>
|
|
<td headers="r1 r58 r61 r62 c2 c5 c7">(0.5)</td>
|
|
<td headers="r1 r58 r61 r62 c2 c5 c8">(1.6)</td>
|
|
<td headers="r1 r58 r61 r62 c2 c6">(0.8)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r63" headers="r1 r58 c1">Two or more of five</th>
|
|
<td headers="r1 r58 r63 c2 c3">6.1</td>
|
|
<td headers="r1 r58 r63 c2 c4">9.8</td>
|
|
<td headers="r1 r58 r63 c2 c5 c7">6.3</td>
|
|
<td headers="r1 r58 r63 c2 c5 c8">11.2</td>
|
|
<td headers="r1 r58 r63 c2 c6">10.9</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r64" headers="r1 r58 c1"></th>
|
|
<td headers="r1 r58 r63 r64 c2 c3">(0.2)</td>
|
|
<td headers="r1 r58 r63 r64 c2 c4">(0.6)</td>
|
|
<td headers="r1 r58 r63 r64 c2 c5 c7">(0.4)</td>
|
|
<td headers="r1 r58 r63 r64 c2 c5 c8">(1.5)</td>
|
|
<td headers="r1 r58 r63 r64 c2 c6">(0.7)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub2" id="r65" headers="r1 r58 r64 c1">Total</th>
|
|
<td headers="r1 r58 r64 r65 c2 c3">100.0</td>
|
|
<td headers="r1 r58 r64 r65 c2 c4">100.0</td>
|
|
<td headers="r1 r58 r64 r65 c2 c5 c7">100.0</td>
|
|
<td headers="r1 r58 r64 r65 c2 c5 c8">100.0</td>
|
|
<td headers="r1 r58 r64 r65 c2 c6">100.0</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r66" headers="r1 c1">Mortality status 4 years after survey reference month</th>
|
|
<td colspan="5"></td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r67" headers="r1 r66 c1">Died by November 2000</th>
|
|
<td headers="r1 r66 r67 c2 c3">0.6</td>
|
|
<td headers="r1 r66 r67 c2 c4">1.0</td>
|
|
<td headers="r1 r66 r67 c2 c5 c7">0.8</td>
|
|
<td headers="r1 r66 r67 c2 c5 c8">0.7</td>
|
|
<td headers="r1 r66 r67 c2 c6">1.3</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r68" headers="r1 r66 c1"></th>
|
|
<td headers="r1 r66 r67 r68 c2 c3">(0.1)</td>
|
|
<td headers="r1 r66 r67 r68 c2 c4">(0.2)</td>
|
|
<td headers="r1 r66 r67 r68 c2 c5 c7">(0.1)</td>
|
|
<td headers="r1 r66 r67 r68 c2 c5 c8">(0.4)</td>
|
|
<td headers="r1 r66 r67 r68 c2 c6">(0.3)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r69" headers="r1 r66 c1">Alive in November 2000</th>
|
|
<td headers="r1 r66 r69 c2 c3">99.4</td>
|
|
<td headers="r1 r66 r69 c2 c4">99.1</td>
|
|
<td headers="r1 r66 r69 c2 c5 c7">99.3</td>
|
|
<td headers="r1 r66 r69 c2 c5 c8">99.3</td>
|
|
<td headers="r1 r66 r69 c2 c6">98.7</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r70" headers="r1 r66 c1"></th>
|
|
<td headers="r1 r66 r69 r70 c2 c3">(0.1)</td>
|
|
<td headers="r1 r66 r69 r70 c2 c4">(0.2)</td>
|
|
<td headers="r1 r66 r69 r70 c2 c5 c7">(0.1)</td>
|
|
<td headers="r1 r66 r69 r70 c2 c5 c8">(0.4)</td>
|
|
<td headers="r1 r66 r69 r70 c2 c6">(0.3)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub2" id="r71" headers="r1 r66 r70 c1">Total</th>
|
|
<td headers="r1 r66 r70 r71 c2 c3">100.0</td>
|
|
<td headers="r1 r66 r70 r71 c2 c4">100.0</td>
|
|
<td headers="r1 r66 r70 r71 c2 c5 c7">100.0</td>
|
|
<td headers="r1 r66 r70 r71 c2 c5 c8">100.0</td>
|
|
<td headers="r1 r66 r70 r71 c2 c6">100.0</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r72" headers="r1 c1">Mortality status 10 years after survey reference month</th>
|
|
<td colspan="5"></td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r73" headers="r1 r72 c1">Died by November 2006</th>
|
|
<td headers="r1 r72 r73 c2 c3">2.1</td>
|
|
<td headers="r1 r72 r73 c2 c4">2.6</td>
|
|
<td headers="r1 r72 r73 c2 c5 c7">2.5</td>
|
|
<td headers="r1 r72 r73 c2 c5 c8">1.7</td>
|
|
<td headers="r1 r72 r73 c2 c6">3.6</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r74" headers="r1 r72 c1"></th>
|
|
<td headers="r1 r72 r73 r74 c2 c3">(0.2)</td>
|
|
<td headers="r1 r72 r73 r74 c2 c4">(0.3)</td>
|
|
<td headers="r1 r72 r73 r74 c2 c5 c7">(0.3)</td>
|
|
<td headers="r1 r72 r73 r74 c2 c5 c8">(0.6)</td>
|
|
<td headers="r1 r72 r73 r74 c2 c6">(0.4)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r75" headers="r1 r72 c1">Alive in November 2006</th>
|
|
<td headers="r1 r72 r75 c2 c3">97.9</td>
|
|
<td headers="r1 r72 r75 c2 c4">97.4</td>
|
|
<td headers="r1 r72 r75 c2 c5 c7">97.5</td>
|
|
<td headers="r1 r72 r75 c2 c5 c8">98.3</td>
|
|
<td headers="r1 r72 r75 c2 c6">96.4</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r76" headers="r1 r72 c1"></th>
|
|
<td headers="r1 r72 r75 r76 c2 c3">(0.2)</td>
|
|
<td headers="r1 r72 r75 r76 c2 c4">(0.3)</td>
|
|
<td headers="r1 r72 r75 r76 c2 c5 c7">(0.3)</td>
|
|
<td headers="r1 r72 r75 r76 c2 c5 c8">(0.6)</td>
|
|
<td headers="r1 r72 r75 r76 c2 c6">(0.4)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub2" id="r77" headers="r1 r72 r76 c1">Total</th>
|
|
<td headers="r1 r72 r76 r77 c2 c3">100.0</td>
|
|
<td headers="r1 r72 r76 r77 c2 c4">100.0</td>
|
|
<td headers="r1 r72 r76 r77 c2 c5 c7">100.0</td>
|
|
<td headers="r1 r72 r76 r77 c2 c5 c8">100.0</td>
|
|
<td headers="r1 r72 r76 r77 c2 c6">100.0</td>
|
|
</tr>
|
|
<tr class="shaded">
|
|
<th class="stub3" id="r78" headers="r1 r72 r76 r77 c1">Total number <sup>d</sup></th>
|
|
<td headers="r1 r72 r76 r77 r78 c2 c3">21,331</td>
|
|
<td headers="r1 r72 r76 r77 r78 c2 c4">5,117</td>
|
|
<td headers="r1 r72 r76 r77 r78 c2 c5 c7">8,953</td>
|
|
<td headers="r1 r72 r76 r77 r78 c2 c5 c8">1,089</td>
|
|
<td headers="r1 r72 r76 r77 r78 c2 c6">4,586</td>
|
|
</tr>
|
|
</tbody>
|
|
<tfoot>
|
|
<tr>
|
|
<td class="firstNote" colspan="6">SOURCE: Survey of Income and Program Participation (<abbr>SIPP</abbr>) matched to Social Security Administration (<abbr class="spell">SSA</abbr>) administrative records, November 1996.</td>
|
|
</tr>
|
|
<tr>
|
|
<td class="note" colspan="6">NOTES: <abbr class="spell">DI</abbr> = Disability Insurance; <abbr class="spell">SSI</abbr> = Supplemental Security Income; <abbr class="spell">ADL</abbr> = activities of daily living; <abbr class="spell">IADL</abbr> = instrumental activities of daily living.</td>
|
|
</tr>
|
|
<tr>
|
|
<td class="note" colspan="6">a. In the calculation of <abbr class="spell">SSI</abbr> financial eligibility own earnings was adjusted to account for the substantial gainful activity ceiling of the <abbr class="spell">SSA</abbr> categorical eligibility screen.</td>
|
|
</tr>
|
|
<tr>
|
|
<td class="note" colspan="6">b. Weighted. Estimated standard errors in parentheses. The standard error estimates assume a design effect of 2.34 to account for the complex <abbr>SIPP</abbr> sample design (see Census Bureau, 2001, Table 4, <abbr title="page">p.</abbr> 22).</td>
|
|
</tr>
|
|
<tr>
|
|
<td class="note" colspan="6">c. Index is sum of the five <span class="nobr">0–1</span> variables. The value "1" is assigned to each of the following: (1) fair or poor self-reported health status; (2) presence of work-preventing or work-limiting condition, reported in two waves; (3) two or more <abbr class="spell">ADL</abbr> limitations or two or more <abbr class="spell">IADL</abbr> limitations; (4) hospitalized during previous 12 months; and (5) more than ten doctor visits during previous 12 months.</td>
|
|
</tr>
|
|
<tr>
|
|
<td class="lastNote" colspan="6">d. Unweighted number of sample observations.</td>
|
|
</tr>
|
|
</tfoot>
|
|
</table>
|
|
</div>
|
|
<p>When we look at subgroup differences, <abbr class="spell">SSI</abbr>-only eligibles tend to be worse off on the various measures of health, disability, and mortality than <abbr class="spell">DI</abbr>-only eligibles. This is notable, because <abbr class="spell">SSI</abbr>-only eligibles tend to be much younger than <abbr class="spell">DI</abbr>-only eligibles. Again, <i>joint</i> eligibles tend to be closer to <abbr class="spell">SSI</abbr>-only eligibles, and <i>serial</i> eligibles tend to be closer to <abbr class="spell">DI</abbr>-only eligibles. However, the members of the noncovered group tend to have somewhat poorer health status and more disabilities than the <abbr class="spell">DI</abbr>-only group, and in fact are fairly close to the <abbr class="spell">SSI</abbr>-only group.<sup><a href="#mn25" id="mt25">25</a></sup> Keep in mind, however, that the health, disability, and mortality indicators are not adjusted for age differences, and <abbr class="spell">SSI</abbr>-only eligibles tend to be much younger than <abbr class="spell">DI</abbr>-only eligibles.</p>
|
|
<p>Table 4 presents several indicators of economic well-being, illustrating how the five groups compare in terms of official poverty status (based on the Census Bureau's official poverty thresholds) and asset indicators. There are marked differences here. As expected, the poverty rate based on current income (including observed own earnings)<sup><a href="#mn26" id="mt26">26</a></sup> is much higher (35 percent) among those who are <abbr class="spell">SSI</abbr>-eligible only than among those who are <abbr class="spell">DI</abbr>-insured only (3 percent). <i>Joint</i> eligibles have a poverty rate (40 percent) that is even higher than the <abbr class="spell">SSI</abbr>-only rate, whereas <i>serial</i> eligibles have a poverty rate (17 percent) that is clearly lower than the rate for the other two <abbr class="spell">SSI</abbr>-covered groups, but higher than the rate for the <abbr class="spell">DI</abbr>-only group. The poverty rate of those who are not covered by either program is 8 percent. This is higher than the poverty rate of the <abbr class="spell">DI</abbr>-insured only group, but much lower than the poverty rate of the three groups covered by <abbr class="spell">SSI</abbr>.</p>
|
|
<div class="table" id="table4">
|
|
<table>
|
|
<caption><span class="tableNumber">Table 4. </span>Economic well-being of <abbr class="spell">DI</abbr> and <abbr class="spell">SSI</abbr> nonparticipants aged <span class="nobr">18–64</span>, by potential access to <abbr class="spell">DI</abbr> and/or <abbr class="spell">SSI</abbr>, November 1996</caption>
|
|
<colgroup span="1" style="width:20em"></colgroup>
|
|
<colgroup span="5" style="width:8em"></colgroup>
|
|
<thead>
|
|
<tr>
|
|
<th class="stubHeading" rowspan="3" id="c1">Characteristic</th>
|
|
<th class="spanner" colspan="5" id="c2">Current nonparticipants by potential access to <abbr class="spell">DI</abbr> and/or <abbr class="spell">SSI</abbr> <sup>a</sup></th>
|
|
</tr>
|
|
<tr>
|
|
<th rowspan="2" id="c3" headers="c2"><abbr class="spell">DI</abbr>-insured<br>only</th>
|
|
<th rowspan="2" id="c4" headers="c2"><abbr class="spell">SSI</abbr>-eligible<br>only</th>
|
|
<th class="spanner" colspan="2" id="c5" headers="c2">Concurrent <abbr class="spell">DI</abbr>/<abbr class="spell">SSI</abbr> eligibles</th>
|
|
<th rowspan="2" id="c6" headers="c2">Neither <abbr class="spell">DI</abbr><br>insured nor<br><abbr class="spell">SSI</abbr> eligible</th>
|
|
</tr>
|
|
<tr>
|
|
<th id="c7" headers="c2 c5">Serial <abbr class="spell">SSI</abbr><br>to <abbr class="spell">DI</abbr></th>
|
|
<th id="c8" headers="c2 c5">Joint <abbr class="spell">SSI</abbr><br>and <abbr class="spell">DI</abbr></th>
|
|
</tr>
|
|
</thead>
|
|
<tbody>
|
|
<tr>
|
|
<td></td>
|
|
<th class="panel" colspan="5" id="r1">Percentage distribution <sup>b</sup></th>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r2" headers="r1 c1">Observed poverty status</th>
|
|
<td colspan="5"></td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r3" headers="r1 r2 c1">Poor</th>
|
|
<td headers="r1 r2 r3 c2 c3">3.4</td>
|
|
<td headers="r1 r2 r3 c2 c4">35.0</td>
|
|
<td headers="r1 r2 r3 c2 c5 c7">16.7</td>
|
|
<td headers="r1 r2 r3 c2 c5 c8">39.5</td>
|
|
<td headers="r1 r2 r3 c2 c6">7.7</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r4" headers="r1 r2 c1"></th>
|
|
<td headers="r1 r2 r3 r4 c2 c3">(0.2)</td>
|
|
<td headers="r1 r2 r3 r4 c2 c4">(1.0)</td>
|
|
<td headers="r1 r2 r3 r4 c2 c5 c7">(0.6)</td>
|
|
<td headers="r1 r2 r3 r4 c2 c5 c8">(2.3)</td>
|
|
<td headers="r1 r2 r3 r4 c2 c6">(0.6)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r5" headers="r1 r2 c1">Nonpoor</th>
|
|
<td headers="r1 r2 r5 c2 c3">96.6</td>
|
|
<td headers="r1 r2 r5 c2 c4">65.0</td>
|
|
<td headers="r1 r2 r5 c2 c5 c7">83.3</td>
|
|
<td headers="r1 r2 r5 c2 c5 c8">60.5</td>
|
|
<td headers="r1 r2 r5 c2 c6">92.3</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r6" headers="r1 r2 c1"></th>
|
|
<td headers="r1 r2 r5 r6 c2 c3">(0.2)</td>
|
|
<td headers="r1 r2 r5 r6 c2 c4">(1.0)</td>
|
|
<td headers="r1 r2 r5 r6 c2 c5 c7">(0.6)</td>
|
|
<td headers="r1 r2 r5 r6 c2 c5 c8">(2.3)</td>
|
|
<td headers="r1 r2 r5 r6 c2 c6">(0.6)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub2" id="r7" headers="r1 r2 r6 c1">Total percent</th>
|
|
<td headers="r1 r2 r6 r7 c2 c3">100.0</td>
|
|
<td headers="r1 r2 r6 r7 c2 c4">100.0</td>
|
|
<td headers="r1 r2 r6 r7 c2 c5 c7">100.0</td>
|
|
<td headers="r1 r2 r6 r7 c2 c5 c8">100.0</td>
|
|
<td headers="r1 r2 r6 r7 c2 c6">100.0</td>
|
|
</tr>
|
|
<tr>
|
|
<td></td>
|
|
<th class="panel" colspan="5" id="r8">Percent of total with characteristics <sup>b</sup></th>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r9" headers="r8 c1">Asset indicators</th>
|
|
<td colspan="5"></td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r10" headers="r8 r9 c1"><abbr class="spell">SSI</abbr>-countable assets below threshold</th>
|
|
<td headers="r8 r9 r10 c2 c3">9.8</td>
|
|
<td headers="r8 r9 r10 c2 c4">100.0</td>
|
|
<td headers="r8 r9 r10 c2 c5 c7">100.0</td>
|
|
<td headers="r8 r9 r10 c2 c5 c8">100.0</td>
|
|
<td headers="r8 r9 r10 c2 c6">11.8</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r11" headers="r8 r9 c1"></th>
|
|
<td headers="r8 r9 r10 r11 c2 c3">(0.3)</td>
|
|
<td headers="r8 r9 r10 r11 c2 c4">(0.0)</td>
|
|
<td headers="r8 r9 r10 r11 c2 c5 c7">(0.0)</td>
|
|
<td headers="r8 r9 r10 r11 c2 c5 c8">(0.0)</td>
|
|
<td headers="r8 r9 r10 r11 c2 c6">(0.7)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r12" headers="r8 r9 c1">Owns car</th>
|
|
<td headers="r8 r9 r12 c2 c3">85.6</td>
|
|
<td headers="r8 r9 r12 c2 c4">41.3</td>
|
|
<td headers="r8 r9 r12 c2 c5 c7">65.4</td>
|
|
<td headers="r8 r9 r12 c2 c5 c8">34.7</td>
|
|
<td headers="r8 r9 r12 c2 c6">82.2</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r13" headers="r8 r9 c1"></th>
|
|
<td headers="r8 r9 r12 r13 c2 c3">(0.4)</td>
|
|
<td headers="r8 r9 r12 r13 c2 c4">(1.1)</td>
|
|
<td headers="r8 r9 r12 r13 c2 c5 c7">(0.8)</td>
|
|
<td headers="r8 r9 r12 r13 c2 c5 c8">(2.2)</td>
|
|
<td headers="r8 r9 r12 r13 c2 c6">(0.9)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r14" headers="r8 r9 c1">Owns home</th>
|
|
<td headers="r8 r9 r14 c2 c3">79.5</td>
|
|
<td headers="r8 r9 r14 c2 c4">48.8</td>
|
|
<td headers="r8 r9 r14 c2 c5 c7">51.1</td>
|
|
<td headers="r8 r9 r14 c2 c5 c8">58.9</td>
|
|
<td headers="r8 r9 r14 c2 c6">79.0</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r15" headers="r8 r9 c1"></th>
|
|
<td headers="r8 r9 r14 r15 c2 c3">(0.4)</td>
|
|
<td headers="r8 r9 r14 r15 c2 c4">(1.1)</td>
|
|
<td headers="r8 r9 r14 r15 c2 c5 c7">(0.8)</td>
|
|
<td headers="r8 r9 r14 r15 c2 c5 c8">(2.3)</td>
|
|
<td headers="r8 r9 r14 r15 c2 c6">(0.9)</td>
|
|
</tr>
|
|
<tr class="shaded">
|
|
<th class="stub3" id="r16" headers="r8 r9 r15 c1">Total number <sup>c</sup></th>
|
|
<td headers="r8 r9 r15 r16 c2 c3">21,331</td>
|
|
<td headers="r8 r9 r15 r16 c2 c4">5,117</td>
|
|
<td headers="r8 r9 r15 r16 c2 c5 c7">8,953</td>
|
|
<td headers="r8 r9 r15 r16 c2 c5 c8">1,089</td>
|
|
<td headers="r8 r9 r15 r16 c2 c6">4,586</td>
|
|
</tr>
|
|
</tbody>
|
|
<tfoot>
|
|
<tr>
|
|
<td class="firstNote" colspan="6">SOURCE: Survey of Income and Program Participation (<abbr>SIPP</abbr>) matched to Social Security Administration (<abbr class="spell">SSA</abbr>) administrative records, November 1996.</td>
|
|
</tr>
|
|
<tr>
|
|
<td class="note" colspan="6">NOTES: <abbr class="spell">DI</abbr> = Disability Insurance; <abbr class="spell">SSI</abbr> = Supplemental Security Income.</td>
|
|
</tr>
|
|
<tr>
|
|
<td class="note" colspan="6">a. In the calculation of <abbr class="spell">SSI</abbr> financial eligibility, own earnings was adjusted to account for the substantial gainful activity ceiling of the <abbr class="spell">SSA</abbr> categorical eligibility screen.</td>
|
|
</tr>
|
|
<tr>
|
|
<td class="note" colspan="6">b. Weighted. Estimated standard errors in parentheses. The standard error estimates assume a design effect of 2.34 to account for the complex <abbr>SIPP</abbr> sample design (see Census Bureau, 2001, Table 4, <abbr title="page">p.</abbr> 22).</td>
|
|
</tr>
|
|
<tr>
|
|
<td class="lastNote" colspan="6">c. Unweighted number of sample observations.</td>
|
|
</tr>
|
|
</tfoot>
|
|
</table>
|
|
</div>
|
|
<p>When we compare the four groups that are covered by one or both programs by automobile and home ownership (neither of which affect <abbr class="spell">SSI</abbr> financial eligibility because the primary residence and in most cases one automobile are not countable resources), a key finding is that <abbr class="spell">DI</abbr>-only eligibles are better off than the three groups covered by <abbr class="spell">SSI</abbr>. Importantly, the group that is not covered by either program stands out as almost indistinguishable from the <abbr class="spell">DI</abbr>-only group. This is consistent with our previous findings of similarities between the two groups and our hypothesis that marriage may provide an important link between these two groups of individuals. While home ownership may provide a financial cushion in the event of disablement for anyone, it may be especially important for this "uncovered" group.</p>
|
|
<p>Consistent with the patterns we observed previously, the proportion of nonparticipants with countable assets below the <abbr class="spell">SSI</abbr> thresholds is about the same—roughly 10 percent—for <abbr class="spell">DI</abbr>-insured only eligibles and those without either <abbr class="spell">DI</abbr> or <abbr class="spell">SSI</abbr> coverage.<sup><a href="#mn27" id="mt27">27</a></sup> Thus roughly 90 percent in both groups are ineligible for <abbr class="spell">SSI</abbr> based on their countable resources, regardless of income eligibility. However, the role of this disqualifying factor is very different for the two groups. The <abbr class="spell">DI</abbr>-only group is by definition "covered," although a small fraction of this group may lose potential <abbr class="spell">SSI</abbr> enhancements as a result of asset ineligibility. However, failure to meet the (fairly low) <abbr class="spell">SSI</abbr> asset threshold may be the sole reason for <abbr class="spell">SSI</abbr> financial ineligibility—and thus the lack of disability benefit coverage altogether—for some among those who are not covered by either <abbr class="spell">DI</abbr> or <abbr class="spell">SSI</abbr>.<sup><a href="#mn28" id="mt28">28</a></sup> We note that there is substantial room for changes in SSI coverage for these two groups over a longer time-horizon.</p>
|
|
<h3>Access to Other Programs</h3>
|
|
<p>Coverage by other programs may increase or reduce the perceived value of <abbr class="spell">DI</abbr>/<abbr class="spell">SSI</abbr> coverage. The perceived value may be affected not only by expected cash benefits, but also by other factors such as associated noncash benefits and the length of the award decision period.<sup><a href="#mn29" id="mt29">29</a></sup> Table 5 provides information on <i>current</i> participation in two means-tested cash-assistance programs (Temporary Assistance for Needy Families (<abbr>TANF</abbr>) and Food Stamp) and four employment-related programs. Three of the employment-related programs explicitly condition eligibility on some definition of disability (workers' compensation (<abbr class="spell">WC</abbr>), veterans' disability benefits, and employer-sponsored disability benefits), although Unemployment Insurance (<abbr class="spell">UI</abbr>) does not. Estimated participation in all but the two means-tested programs is low. This qualitative conclusion should hold despite possible <abbr>SIPP</abbr> undercounting (Meyer and Sullivan 2006). Not surprisingly, <abbr>TANF</abbr> and Food Stamp participation is highest among <abbr class="spell">SSI</abbr>-only eligibles, closely followed by <i>joint</i> eligibles. Though the rate of participation in work-related programs is low among <abbr class="spell">DI</abbr>-only eligibles across the board, the point estimates are higher than for any of the <abbr class="spell">SSI</abbr>-covered groups.</p>
|
|
<div class="table" id="table5">
|
|
<table>
|
|
<caption><span class="tableNumber">Table 5. </span>Estimated receipt of cash benefits from various programs among <abbr class="spell">DI</abbr> and <abbr class="spell">SSI</abbr> nonparticipants aged <span class="nobr">18–64</span>, by potential access to <abbr class="spell">DI</abbr> and/or <abbr class="spell">SSI</abbr>, November 1996</caption>
|
|
<colgroup span="1" style="width:18em"></colgroup>
|
|
<colgroup span="5" style="width:8em"></colgroup>
|
|
<thead>
|
|
<tr>
|
|
<th class="stubHeading" rowspan="3" id="c1">Program</th>
|
|
<th class="spanner" colspan="5" id="c2">Current nonparticipants by potential access to <abbr class="spell">DI</abbr> and/or <abbr class="spell">SSI</abbr> <sup>a</sup></th>
|
|
</tr>
|
|
<tr>
|
|
<th rowspan="2" id="c3" headers="c2"><abbr class="spell">DI</abbr>-insured<br>only</th>
|
|
<th rowspan="2" id="c4" headers="c2"><abbr class="spell">SSI</abbr>-eligible<br>only</th>
|
|
<th class="spanner" colspan="2" id="c5" headers="c2">Concurrent <abbr class="spell">DI</abbr>/<abbr class="spell">SSI</abbr> eligibles</th>
|
|
<th rowspan="2" id="c6" headers="c2">Neither <abbr class="spell">DI</abbr><br>nor <abbr class="spell">SSI</abbr></th>
|
|
</tr>
|
|
<tr>
|
|
<th id="c7" headers="c2 c5">Serial <abbr class="spell">SSI</abbr> to<br><abbr class="spell">DI</abbr></th>
|
|
<th id="c8" headers="c2 c5">Joint <abbr class="spell">SSI</abbr><br>and <abbr class="spell">DI</abbr></th>
|
|
</tr>
|
|
</thead>
|
|
<tbody>
|
|
<tr>
|
|
<td></td>
|
|
<th class="panel" colspan="5" id="r1">Percent of total currently receiving <sup>b</sup></th>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r2" headers="r1 c1">Temporary Assistance for Needy Families</th>
|
|
<td headers="r1 r2 c2 c3">0.41</td>
|
|
<td headers="r1 r2 c2 c4">14.09</td>
|
|
<td headers="r1 r2 c2 c5 c7">2.85</td>
|
|
<td headers="r1 r2 c2 c5 c8">10.57</td>
|
|
<td headers="r1 r2 c2 c6">1.08</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r3" headers="r1 r2 c1"></th>
|
|
<td headers="r1 r2 r3 c2 c3">(0.07)</td>
|
|
<td headers="r1 r2 r3 c2 c4">(0.74)</td>
|
|
<td headers="r1 r2 r3 c2 c5 c7">(0.27)</td>
|
|
<td headers="r1 r2 r3 c2 c5 c8">(1.43)</td>
|
|
<td headers="r1 r2 r3 c2 c6">(0.23)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r4" headers="r1 c1">Food Stamp</th>
|
|
<td headers="r1 r4 c2 c3">1.11</td>
|
|
<td headers="r1 r4 c2 c4">24.08</td>
|
|
<td headers="r1 r4 c2 c5 c7">7.94</td>
|
|
<td headers="r1 r4 c2 c5 c8">20.15</td>
|
|
<td headers="r1 r4 c2 c6">2.70</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r5" headers="r1 r4 c1"></th>
|
|
<td headers="r1 r4 r5 c2 c3">(0.11)</td>
|
|
<td headers="r1 r4 r5 c2 c4">(0.91)</td>
|
|
<td headers="r1 r4 r5 c2 c5 c7">(0.44)</td>
|
|
<td headers="r1 r4 r5 c2 c5 c8">(1.86)</td>
|
|
<td headers="r1 r4 r5 c2 c6">(0.37)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r6" headers="r1 c1">Workers' compensation</th>
|
|
<td headers="r1 r6 c2 c3">0.40</td>
|
|
<td headers="r1 r6 c2 c4">0.11</td>
|
|
<td headers="r1 r6 c2 c5 c7">0.09</td>
|
|
<td headers="r1 r6 c2 c5 c8">0.02</td>
|
|
<td headers="r1 r6 c2 c6">1.06</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r7" headers="r1 r6 c1"></th>
|
|
<td headers="r1 r6 r7 c2 c3">(0.07)</td>
|
|
<td headers="r1 r6 r7 c2 c4">(0.07)</td>
|
|
<td headers="r1 r6 r7 c2 c5 c7">(0.05)</td>
|
|
<td headers="r1 r6 r7 c2 c5 c8">(0.07)</td>
|
|
<td headers="r1 r6 r7 c2 c6">(0.23)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r8" headers="r1 c1">Veterans' disability benefits</th>
|
|
<td headers="r1 r8 c2 c3">0.92</td>
|
|
<td headers="r1 r8 c2 c4">0.27</td>
|
|
<td headers="r1 r8 c2 c5 c7">0.28</td>
|
|
<td headers="r1 r8 c2 c5 c8">0.00</td>
|
|
<td headers="r1 r8 c2 c6">0.93</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r9" headers="r1 r8 c1"></th>
|
|
<td headers="r1 r8 r9 c2 c3">(0.10)</td>
|
|
<td headers="r1 r8 r9 c2 c4">(0.11)</td>
|
|
<td headers="r1 r8 r9 c2 c5 c7">(0.09)</td>
|
|
<td headers="r1 r8 r9 c2 c5 c8">(0.00)</td>
|
|
<td headers="r1 r8 r9 c2 c6">(0.22)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r10" headers="r1 c1">Employer-sponsored disability benefits</th>
|
|
<td headers="r1 r10 c2 c3">0.18</td>
|
|
<td headers="r1 r10 c2 c4">0.02</td>
|
|
<td headers="r1 r10 c2 c5 c7">0.03</td>
|
|
<td headers="r1 r10 c2 c5 c8">0.00</td>
|
|
<td headers="r1 r10 c2 c6">0.25</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r11" headers="r1 r10 c1"></th>
|
|
<td headers="r1 r10 r11 c2 c3">(0.04)</td>
|
|
<td headers="r1 r10 r11 c2 c4">(0.03)</td>
|
|
<td headers="r1 r10 r11 c2 c5 c7">(0.03)</td>
|
|
<td headers="r1 r10 r11 c2 c5 c8">(0.00)</td>
|
|
<td headers="r1 r10 r11 c2 c6">(0.11)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r12" headers="r1 c1">Unemployment Insurance</th>
|
|
<td headers="r1 r12 c2 c3">1.39</td>
|
|
<td headers="r1 r12 c2 c4">0.48</td>
|
|
<td headers="r1 r12 c2 c5 c7">0.87</td>
|
|
<td headers="r1 r12 c2 c5 c8">0.28</td>
|
|
<td headers="r1 r12 c2 c6">0.64</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r13" headers="r1 r12 c1"></th>
|
|
<td headers="r1 r12 r13 c2 c3">(0.12)</td>
|
|
<td headers="r1 r12 r13 c2 c4">(0.15)</td>
|
|
<td headers="r1 r12 r13 c2 c5 c7">(0.15)</td>
|
|
<td headers="r1 r12 r13 c2 c5 c8">(0.24)</td>
|
|
<td headers="r1 r12 r13 c2 c6">(0.18)</td>
|
|
</tr>
|
|
<tr class="shaded">
|
|
<th class="stub1" id="r14" headers="r1 r12 c1">Total number <sup>c</sup></th>
|
|
<td headers="r1 r12 r14 c2 c3">21,331</td>
|
|
<td headers="r1 r12 r14 c2 c4">5,117</td>
|
|
<td headers="r1 r12 r14 c2 c5 c7">8,953</td>
|
|
<td headers="r1 r12 r14 c2 c5 c8">1,089</td>
|
|
<td headers="r1 r12 r14 c2 c6">4,586</td>
|
|
</tr>
|
|
</tbody>
|
|
<tfoot>
|
|
<tr>
|
|
<td class="firstNote" colspan="6">SOURCE: Survey of Income and Program Participation (<abbr>SIPP</abbr>) matched to Social Security Administration (<abbr class="spell">SSA</abbr>) administrative records, November 1996.</td>
|
|
</tr>
|
|
<tr>
|
|
<td class="note" colspan="6">NOTES: <abbr class="spell">DI</abbr> = Disability Insurance; <abbr class="spell">SSI</abbr> = Supplemental Security Income.</td>
|
|
</tr>
|
|
<tr>
|
|
<td class="note" colspan="6">a. In the calculation of <abbr class="spell">SSI</abbr> financial eligibility, own earnings was adjusted to account for the substantial gainful activity ceiling of the <abbr class="spell">SSA</abbr> categorical eligibility screen.</td>
|
|
</tr>
|
|
<tr>
|
|
<td class="note" colspan="6">b. Weighted. Estimated standard errors in parentheses. The standard error estimates assume a design effect of 2.34 to account for the complex <abbr>SIPP</abbr> sample design (see Census Bureau, 2001, Table 4, <abbr title="page">p.</abbr> 22).</td>
|
|
</tr>
|
|
<tr>
|
|
<td class="lastNote" colspan="6">c. Unweighted number of sample observations.</td>
|
|
</tr>
|
|
</tfoot>
|
|
</table>
|
|
</div>
|
|
<p>Table 5 reflects participation in other programs at a given point in time (November 1996). However, from a dynamic perspective these other programs may form a bridge towards <abbr class="spell">DI</abbr> or <abbr class="spell">SSI</abbr> <i>entry</i>.<sup><a href="#mn30" id="mt30">30</a></sup> More detailed data (not tabulated) on participation in the six programs by employment status are suggestive in this regard. For the <abbr class="spell">DI</abbr>-only subgroup, participation in <abbr class="spell">UI</abbr> is relatively high (6 percent) among those currently <i>not</i> employed. <abbr>TANF</abbr> participation among currently <i>not</i> employed <abbr class="spell">SSI</abbr>-only eligibles is 22.3 percent in contrast to 7.6 percent for the currently employed. Food Stamp participation among <abbr class="spell">SSI</abbr>-only eligibles shows a similar contrast: 34 percent for those <i>not</i> currently employed compared with only 16 percent for the currently employed. Participation among those <i>not</i> currently employed tends to be relatively high across the board, as we should expect.</p>
|
|
<p>A related limitation of the <abbr>SIPP</abbr> information is that it refers to observed current participation rather than a broader concept of "access" or coverage. For example, we would like to identify those who are covered by <abbr class="spell">WC</abbr> or <abbr class="spell">UI</abbr>, but unfortunately we cannot do so with the <abbr>SIPP</abbr>. However, we can rely on aggregate data to gauge coverage by these other programs. For example, in 2004, <abbr class="spell">WC</abbr> covered 67 percent of the working-age population. The federal/state <abbr class="spell">UI</abbr> and unemployment compensation for federal employees programs covered 69 percent of the working-age population (authors' calculations based on National Academy of Social Insurance (2006)).<sup><a href="#mn31" id="mt31">31</a></sup></p>
|
|
<p>Workers' compensation is both a substitute and complement to the <abbr class="spell">DI</abbr> program. It is a complement in that people may receive <abbr class="spell">WC</abbr> during the <span class="nobr">5-month</span> <abbr class="spell">DI</abbr> waiting period and beyond or as a lump-sum payment. Access to <abbr class="spell">WC</abbr> benefits during the <span class="nobr">5-month</span> <abbr class="spell">DI</abbr> waiting period provides an alternative to <abbr class="spell">SSI</abbr> among those covered by both <abbr class="spell">DI</abbr> and <abbr class="spell">SSI</abbr>. In addition, <abbr class="spell">WC</abbr> may pay for medical care. <abbr class="spell">DI</abbr> benefits are offset for <abbr class="spell">WC</abbr> beneficiaries, which reduces the incentive to apply for <abbr class="spell">DI</abbr>. Alternatively, an injured person may not file for <abbr class="spell">WC</abbr> in the anticipation of <abbr class="spell">DI</abbr>. Workers' compensation coverage is employment-related, so we surmise that it is mostly relevant for the <abbr class="spell">DI</abbr>-insured and provides virtually no coverage for <abbr class="spell">SSI</abbr>-only eligibles. Based on a comparison of national coverage rates we infer that some <abbr class="spell">DI</abbr>-insured are not covered by <abbr class="spell">WC</abbr>.</p>
|
|
<p>Unemployment Insurance is clearly a complement for <abbr class="spell">DI</abbr>-only eligibles by potentially providing coverage during the <span class="nobr">5-month</span> <abbr class="spell">DI</abbr> waiting period. In contrast, among concurrent <abbr class="spell">SSI</abbr>/<abbr class="spell">DI</abbr> eligibles, <abbr class="spell">UI</abbr> could serve as a substitute for <abbr class="spell">SSI</abbr> during the <abbr class="spell">DI</abbr> waiting period. Note that there is an apparent inconsistency between the <abbr class="spell">UI</abbr> requirement of active job search and availability to work and the need for successful <abbr class="spell">DI</abbr> applicants to prove inability to work. However, <abbr class="spell">UI</abbr> can serve as a bridge to <abbr class="spell">DI</abbr> in some cases. Disablement is a process with uncertain outcomes, and a <abbr class="spell">UI</abbr> applicant's disability may get progressively worse. Unsuccessful job search can also provide evidence to the potential applicant—and to <abbr class="spell">SSA</abbr>—of inability to work. Similar to <abbr class="spell">WC</abbr>, <abbr class="spell">UI</abbr> is probably not relevant for most <abbr class="spell">SSI</abbr>-only eligibles because it is conditioned on the presence of a recent period of employment.</p>
|
|
<p>A comprehensive analysis of interactions with other cash-assistance programs is beyond the scope of this article. Assessing the interactions of <abbr class="spell">SSI</abbr> and <abbr class="spell">DI</abbr> with alternative cash-assistance programs ideally would require an analytic framework and data that support measurement of coverage by all of the relevant programs in a manner similar to our calculation of <abbr class="spell">DI</abbr> and <abbr class="spell">SSI</abbr> coverage. Short of such data, one can make some inferences from information on the scope of coverage, offset provisions, eligibility requirements, and relative attractiveness of potential cash benefits from the various programs. With respect to scope of access, we can hypothesize that interactions with State Disability Insurance (<abbr class="spell">SDI</abbr>) programs are less important than interactions with workers' compensation, simply because the former are available only in five states. With respect to eligibility requirements, means testing limits <abbr>TANF</abbr> and Food Stamp coverage. Further, <abbr>TANF</abbr> is also limited to working-age adults with children, and access to veterans' disability benefits are limited to a nontrivial, but small fraction of men and to an even smaller fraction of women. Conditional on meeting program-specific eligibility screens, interactions with other programs will also differ depending on the amount of expected benefits (relatively low in <abbr>TANF</abbr>, relatively high in <abbr class="spell">WC</abbr>); rules limiting receipt of benefits from both programs (the same person cannot simultaneously receive benefits from both <abbr>TANF</abbr> and <abbr class="spell">SSI</abbr>); and benefit offset provisions (<abbr class="spell">DI</abbr> benefits offset by <abbr class="spell">WC</abbr> benefits).</p>
|
|
<p>Overall, we can reach several broad conclusions. First, although interactions with other cash-assistance programs are important, their overall importance probably does not match the importance of interactions between the <abbr class="spell">SSI</abbr> and <abbr class="spell">DI</abbr> programs (Burkhauser and Wittenburg 1996; Honeycutt 2004). Second, other programs can have features of both substitutes and complements, as is the case with <abbr class="spell">WC</abbr>. Third, some programs (for example, <abbr class="spell">SDI</abbr> programs and <abbr class="spell">UI</abbr>) may be a complement to <abbr class="spell">DI</abbr> but a substitute to <abbr class="spell">SSI</abbr> for concurrent eligibles during the <span class="nobr">5-month</span> <abbr class="spell">DI</abbr> waiting period. Fourth, the frequent lack of employment experience among <abbr class="spell">SSI</abbr>-only eligibles<sup><a href="#mn32" id="mt32">32</a></sup> makes work-related cash programs less relevant for them compared with those programs' importance for <abbr class="spell">DI</abbr> eligibles (including concurrents). Fifth, means testing in <abbr>TANF</abbr> and the Food Stamp program severely limits access to cash-benefit programs among the <abbr class="spell">DI</abbr> only. Finally, <abbr class="spell">DI</abbr>-offset provisions and the <abbr class="spell">SSI</abbr> income test reduce the relative attractiveness of access to other cash-assistance programs.</p>
|
|
<h3>Access to Health Insurance</h3>
|
|
<p>Access to health insurance is an important topic for a number of reasons. Of particular relevance is that <abbr class="spell">SSI</abbr> awardees are categorically eligible for Medicaid in most cases. Another factor is the <span class="nobr">24-month</span> Medicare waiting period for new <abbr class="spell">DI</abbr> awardees. These program features may increase the incentive to apply for <abbr class="spell">SSI</abbr> payments. Whether such incentives are important or not, however, critically depends on access to health insurance through other venues.</p>
|
|
<p>Table 6 provides the percentage of eligible nonparticipants reporting access to various private or public sources of health insurance and a summary row providing the percentage with access to health insurance from any source. The <abbr class="spell">DI</abbr>-insured and the <abbr class="spell">SSI</abbr>-eligible groups provide some clear contrasts. First, about 20 percent of <abbr class="spell">SSI</abbr>-only eligible nonparticipants are Medicaid beneficiaries, and Medicaid is a negligible source of health insurance for those covered by <abbr class="spell">DI</abbr> only. The <abbr class="spell">SSI</abbr> finding suggests that <abbr class="spell">SSI</abbr>-based access to Medicaid may not be critical for a notable minority of <abbr class="spell">SSI</abbr>-only eligibles, because they have access to Medicaid through other venues.<sup><a href="#mn33" id="mt33">33</a></sup> Second, health insurance through the employer of the reference person is very important for the <abbr class="spell">DI</abbr>-only group of nonparticipants, though it is relatively unimportant for the <abbr class="spell">SSI</abbr>-only group. Third, almost one-third of both groups have access to health insurance under someone else's plan. Finally, all except for a small fraction of the <abbr class="spell">DI</abbr>-only group have access to health insurance from some source, although over one-third of <abbr class="spell">SSI</abbr>-only eligibles appear to be uninsured.</p>
|
|
<div class="table" id="table6">
|
|
<table>
|
|
<caption><span class="tableNumber">Table 6. </span>Access to health insurance among <abbr class="spell">DI</abbr> and <abbr class="spell">SSI</abbr> nonparticipants aged <span class="nobr">18–64</span>, by potential access to <abbr class="spell">DI</abbr> and/or <abbr class="spell">SSI</abbr>, November 1996</caption>
|
|
<colgroup span="1" style="width:20em"></colgroup>
|
|
<colgroup span="5" style="width:8em"></colgroup>
|
|
<thead>
|
|
<tr>
|
|
<th class="stubHeading" rowspan="3" id="c1">Health insurance status</th>
|
|
<th class="spanner" colspan="5" id="c2">Current nonparticipants by potential access to <abbr class="spell">DI</abbr> and/or <abbr class="spell">SSI</abbr> <sup>a</sup></th>
|
|
</tr>
|
|
<tr>
|
|
<th rowspan="2" id="c3" headers="c2"><abbr class="spell">DI</abbr>-insured<br>only</th>
|
|
<th rowspan="2" id="c4" headers="c2"><abbr class="spell">SSI</abbr>-eligible<br>only</th>
|
|
<th class="spanner" colspan="2" id="c5" headers="c2">Concurrent <abbr class="spell">DI</abbr>/<abbr class="spell">SSI</abbr> eligibles</th>
|
|
<th rowspan="2" id="c6" headers="c2">Neither <abbr class="spell">DI</abbr><br>nor <abbr class="spell">SSI</abbr></th>
|
|
</tr>
|
|
<tr>
|
|
<th id="c7" headers="c2 c5">Serial <abbr class="spell">SSI</abbr><br>to <abbr class="spell">DI</abbr></th>
|
|
<th id="c8" headers="c2 c5">Joint <abbr class="spell">SSI</abbr><br>and <abbr class="spell">DI</abbr></th>
|
|
</tr>
|
|
</thead>
|
|
<tbody>
|
|
<tr>
|
|
<td></td>
|
|
<th class="panel" colspan="5" id="r1">Percentage distribution <sup>b</sup></th>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r2" headers="r1 c1">Health insurance from any source <sup>c</sup></th>
|
|
<td headers="r1 r2 c2 c3">94.5</td>
|
|
<td headers="r1 r2 c2 c4">63.8</td>
|
|
<td headers="r1 r2 c2 c5 c7">68.6</td>
|
|
<td headers="r1 r2 c2 c5 c8">65.9</td>
|
|
<td headers="r1 r2 c2 c6">89.2</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r3" headers="r1 r2 c1"></th>
|
|
<td headers="r1 r2 r3 c2 c3">(0.2)</td>
|
|
<td headers="r1 r2 r3 c2 c4">(1.0)</td>
|
|
<td headers="r1 r2 r3 c2 c5 c7">(0.8)</td>
|
|
<td headers="r1 r2 r3 c2 c5 c8">(2.2)</td>
|
|
<td headers="r1 r2 r3 c2 c6">(0.7)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r4" headers="r1 c1">No health insurance <sup>d</sup></th>
|
|
<td headers="r1 r4 c2 c3">5.5</td>
|
|
<td headers="r1 r4 c2 c4">36.2</td>
|
|
<td headers="r1 r4 c2 c5 c7">31.4</td>
|
|
<td headers="r1 r4 c2 c5 c8">34.1</td>
|
|
<td headers="r1 r4 c2 c6">10.8</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r5" headers="r1 r4 c1"></th>
|
|
<td headers="r1 r4 r5 c2 c3">(0.2)</td>
|
|
<td headers="r1 r4 r5 c2 c4">(1.0)</td>
|
|
<td headers="r1 r4 r5 c2 c5 c7">(0.8)</td>
|
|
<td headers="r1 r4 r5 c2 c5 c8">(2.2)</td>
|
|
<td headers="r1 r4 r5 c2 c6">(0.7)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r6" headers="r1 r4 c1"></th>
|
|
<td colspan="5"></td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r7" headers="r1 r4 c1">Total</th>
|
|
<td headers="r1 r4 r7 c2 c3">100.0</td>
|
|
<td headers="r1 r4 r7 c2 c4">100.0</td>
|
|
<td headers="r1 r4 r7 c2 c5 c7">100.0</td>
|
|
<td headers="r1 r4 r7 c2 c5 c8">100.0</td>
|
|
<td headers="r1 r4 r7 c2 c6">100.0</td>
|
|
</tr>
|
|
<tr>
|
|
<td></td>
|
|
<th class="panel" colspan="5" id="r8">Percent of total with characteristics <sup>b</sup></th>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r9" headers="r8 c1">Medicaid</th>
|
|
<td headers="r8 r9 c2 c3">0.6</td>
|
|
<td headers="r8 r9 c2 c4">20.2</td>
|
|
<td headers="r8 r9 c2 c5 c7">5.3</td>
|
|
<td headers="r8 r9 c2 c5 c8">16.1</td>
|
|
<td headers="r8 r9 c2 c6">2.0</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r10" headers="r8 r9 c1"></th>
|
|
<td headers="r8 r9 r10 c2 c3">(0.1)</td>
|
|
<td headers="r8 r9 r10 c2 c4">(0.9)</td>
|
|
<td headers="r8 r9 r10 c2 c5 c7">(0.4)</td>
|
|
<td headers="r8 r9 r10 c2 c5 c8">(1.7)</td>
|
|
<td headers="r8 r9 r10 c2 c6">(0.3)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r11" headers="r8 c1">Medicare</th>
|
|
<td headers="r8 r11 c2 c3">0.2</td>
|
|
<td headers="r8 r11 c2 c4">1.0</td>
|
|
<td headers="r8 r11 c2 c5 c7">0.4</td>
|
|
<td headers="r8 r11 c2 c5 c8">0.8</td>
|
|
<td headers="r8 r11 c2 c6">0.9</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r12" headers="r8 r11 c1"></th>
|
|
<td headers="r8 r11 r12 c2 c3">(0.0)</td>
|
|
<td headers="r8 r11 r12 c2 c4">(0.2)</td>
|
|
<td headers="r8 r11 r12 c2 c5 c7">(0.1)</td>
|
|
<td headers="r8 r11 r12 c2 c5 c8">(0.4)</td>
|
|
<td headers="r8 r11 r12 c2 c6">(0.2)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r13" headers="r8 c1">Health insurance in own name, private</th>
|
|
<td headers="r8 r13 c2 c3">4.3</td>
|
|
<td headers="r8 r13 c2 c4">2.7</td>
|
|
<td headers="r8 r13 c2 c5 c7">3.6</td>
|
|
<td headers="r8 r13 c2 c5 c8">4.5</td>
|
|
<td headers="r8 r13 c2 c6">4.2</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r14" headers="r8 r13 c1"></th>
|
|
<td headers="r8 r13 r14 c2 c3">(0.2)</td>
|
|
<td headers="r8 r13 r14 c2 c4">(0.3)</td>
|
|
<td headers="r8 r13 r14 c2 c5 c7">(0.3)</td>
|
|
<td headers="r8 r13 r14 c2 c5 c8">(1.0)</td>
|
|
<td headers="r8 r13 r14 c2 c6">(0.5)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r15" headers="r8 c1">Health insurance in own name, employer</th>
|
|
<td headers="r8 r15 c2 c3">63.2</td>
|
|
<td headers="r8 r15 c2 c4">12.1</td>
|
|
<td headers="r8 r15 c2 c5 c7">46.9</td>
|
|
<td headers="r8 r15 c2 c5 c8">6.7</td>
|
|
<td headers="r8 r15 c2 c6">31.1</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r16" headers="r8 r15 c1"></th>
|
|
<td headers="r8 r15 r16 c2 c3">(0.5)</td>
|
|
<td headers="r8 r15 r16 c2 c4">(0.7)</td>
|
|
<td headers="r8 r15 r16 c2 c5 c7">(0.8)</td>
|
|
<td headers="r8 r15 r16 c2 c5 c8">(1.2)</td>
|
|
<td headers="r8 r15 r16 c2 c6">(1.0)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r17" headers="r8 c1">Health insurance in own name, military</th>
|
|
<td headers="r8 r17 c2 c3">1.1</td>
|
|
<td headers="r8 r17 c2 c4">0.4</td>
|
|
<td headers="r8 r17 c2 c5 c7">0.9</td>
|
|
<td headers="r8 r17 c2 c5 c8">0.5</td>
|
|
<td headers="r8 r17 c2 c6">0.8</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r18" headers="r8 r17 c1"></th>
|
|
<td headers="r8 r17 r18 c2 c3">(0.1)</td>
|
|
<td headers="r8 r17 r18 c2 c4">(0.1)</td>
|
|
<td headers="r8 r17 r18 c2 c5 c7">(0.2)</td>
|
|
<td headers="r8 r17 r18 c2 c5 c8">(0.3)</td>
|
|
<td headers="r8 r17 r18 c2 c6">(0.2)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r19" headers="r8 c1">Health insurance under someone else's plan</th>
|
|
<td headers="r8 r19 c2 c3">32.9</td>
|
|
<td headers="r8 r19 c2 c4">29.5</td>
|
|
<td headers="r8 r19 c2 c5 c7">14.0</td>
|
|
<td headers="r8 r19 c2 c5 c8">38.1</td>
|
|
<td headers="r8 r19 c2 c6">55.2</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r20" headers="r8 r19 c1"></th>
|
|
<td headers="r8 r19 r20 c2 c3">(0.5)</td>
|
|
<td headers="r8 r19 r20 c2 c4">(1.0)</td>
|
|
<td headers="r8 r19 r20 c2 c5 c7">(0.6)</td>
|
|
<td headers="r8 r19 r20 c2 c5 c8">(2.3)</td>
|
|
<td headers="r8 r19 r20 c2 c6">(1.1)</td>
|
|
</tr>
|
|
<tr class="shaded">
|
|
<th class="stub2" id="r21" headers="r8 r19 r20 c1">Total number <sup>e</sup></th>
|
|
<td headers="r8 r19 r20 r21 c2 c3">21,331</td>
|
|
<td headers="r8 r19 r20 r21 c2 c4">5,117</td>
|
|
<td headers="r8 r19 r20 r21 c2 c5 c7">8,953</td>
|
|
<td headers="r8 r19 r20 r21 c2 c5 c8">1,089</td>
|
|
<td headers="r8 r19 r20 r21 c2 c6">4,586</td>
|
|
</tr>
|
|
</tbody>
|
|
<tfoot>
|
|
<tr>
|
|
<td class="firstNote" colspan="6">SOURCE: Survey of Income and Program Participation (<abbr>SIPP</abbr>) matched to Social Security Administration (<abbr class="spell">SSA</abbr>) administrative records, November 1996.</td>
|
|
</tr>
|
|
<tr>
|
|
<td class="note" colspan="6">NOTES: <abbr class="spell">DI</abbr> = Disability Insurance; <abbr class="spell">SSI</abbr> = Supplemental Security Income.</td>
|
|
</tr>
|
|
<tr>
|
|
<td class="note" colspan="6">a. In the calculation of <abbr class="spell">SSI</abbr> financial eligibility, own earnings was adjusted to account for the substantial gainful activity ceiling of the <abbr class="spell">SSA</abbr> categorical eligibility screen.</td>
|
|
</tr>
|
|
<tr>
|
|
<td class="note" colspan="6">b. Weighted. Estimated standard errors in parentheses. The standard error estimates assume a design effect of 2.34 to account for the complex <abbr>SIPP</abbr> sample design (see Census Bureau, 2001, Table 4, <abbr title="page">p.</abbr> 22).</td>
|
|
</tr>
|
|
<tr>
|
|
<td class="note" colspan="6">c. Includes people with health insurance from more than one source.</td>
|
|
</tr>
|
|
<tr>
|
|
<td class="note" colspan="6">d. No health insurance from any of the six sources listed in bottom panel of table.</td>
|
|
</tr>
|
|
<tr>
|
|
<td class="lastNote" colspan="6">e. Unweighted number of sample observations.</td>
|
|
</tr>
|
|
</tfoot>
|
|
</table>
|
|
</div>
|
|
<p>We note that some <abbr class="spell">DI</abbr>-only eligibles might lose access to employer-provided health insurance as a result of a potential disability shock, and some <abbr class="spell">SSI</abbr>-only eligibles might gain eligibility for Medicaid through some non-<abbr class="spell">SSI</abbr> category of Medicaid eligibility. Still, the contrast between the two groups is suggestive of differential access to health insurance. The data also suggest that lack of access to Medicaid may not be a huge problem for most in the <abbr class="spell">DI</abbr>-only group, and categorical Medicaid eligibility attributable to <abbr class="spell">SSI</abbr> may be important only for about a third of <abbr class="spell">SSI</abbr>-only eligibles who are not currently covered by any health insurance. This is a sizable subgroup, but clearly much less than 100 percent. Nevertheless, the implications of these conclusions are not entirely straightforward, because they are based on cross-sectional data, and disability shocks may be related to changes, such as changes in employment status, that modify access to health insurance. Chart 4 (top panel) shows, for example, that currently employed <abbr class="spell">DI</abbr>-only eligibles are much more likely to have access to own employer-provided health insurance (70 percent) than those who are not currently employed (26 percent), but access to other private insurance (spouse or dependent coverage) may partially compensate for this.<sup><a href="#mn34" id="mt34">34</a></sup> Chart 4 (bottom panel) shows that access to health insurance among <abbr class="spell">SSI</abbr>-only eligibles through Medicaid and family members is higher among those who are not employed than among those who are employed.<sup><a href="#mn35" id="mt35">35</a></sup> Among <abbr class="spell">SSI</abbr>-only eligibles, those who are not currently employed have greater access to Medicaid or health insurance under other people's policies than those who are employed. In contrast to the <abbr class="spell">DI</abbr>-only group, Medicaid and/or health insurance through family members more than fully compensate for the lower coverage through own health insurance among the not employed.</p>
|
|
<div class="chartCenter">
|
|
<div class="chart700" id="chart4">
|
|
<div class="title">Chart 4.<br>Percent of <abbr class="spell">DI</abbr>-insured and <abbr class="spell">SSI</abbr>-only eligible nonparticipants with health insurance from three major sources, by employment status, November 1996</div>
|
|
<div class="scrollChart"><img src="v68n1p1_chart04.gif" alt="Two bar charts with tabular version below." width="700" height="712" /></div>
|
|
<div class="table altTable"><a class="altToggle" href="">Show as table</a>
|
|
<table>
|
|
<caption><span class="tableNumber">Table equivalent for Chart 4. </span>Percent of <abbr class="spell">DI</abbr>-insured only and <abbr class="spell">SSI</abbr>-only eligible nonparticipants with health insurance from three major sources, by employment status, November 1996</caption>
|
|
<colgroup span="1" style="width:10em"></colgroup>
|
|
<colgroup span="2" style="width:8em"></colgroup>
|
|
<colgroup span="2" style="width:8em"></colgroup>
|
|
<thead>
|
|
<tr>
|
|
<th class="stubHeading" rowspan="2" scope="colgroup">Coverage</th>
|
|
<th class="spanner" colspan="2" scope="colgroup">Covered by <abbr class="spell">DI</abbr> only</th>
|
|
<th class="spanner" colspan="2" scope="colgroup">Covered by <abbr class="spell">SSI</abbr> only</th>
|
|
</tr>
|
|
<tr>
|
|
<th scope="col">Currently<br>employed</th>
|
|
<th scope="col">Currently<br>not employed</th>
|
|
<th scope="col">Currently<br>employed</th>
|
|
<th scope="col">Currently<br>not employed</th>
|
|
</tr>
|
|
</thead>
|
|
<tbody>
|
|
<tr>
|
|
<th class="stub0" scope="rowgroup">Medicaid</th>
|
|
<td>0.53</td>
|
|
<td>1.61</td>
|
|
<td>11.92</td>
|
|
<td>30.48</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="rowgroup">Own health insurance</th>
|
|
<td>70.40</td>
|
|
<td>26.18</td>
|
|
<td>23.44</td>
|
|
<td>3.93</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="rowgroup">Insured under another's policy</th>
|
|
<td>30.96</td>
|
|
<td>60.07</td>
|
|
<td>27.80</td>
|
|
<td>31.64</td>
|
|
</tr>
|
|
</tbody>
|
|
<tfoot>
|
|
<tr>
|
|
<td class="noNotes" colspan="5"> </td>
|
|
</tr>
|
|
</tfoot>
|
|
</table>
|
|
</div>
|
|
<div class="firstNote">SOURCE: Survey of Income and Program Participation matched to Social Security Administration administrative records, November 1996.</div>
|
|
<div class="note">NOTES: Some persons may have coverage from more than one source; the percentages are not additive.</div>
|
|
<div class="lastNote"><abbr class="spell">DI</abbr> = Disability Insurance; <abbr class="spell">SSI</abbr> = Supplemental Security Income.</div>
|
|
</div>
|
|
</div>
|
|
<p>Generally, the two groups of concurrent eligibles are in between these two contrasting patterns. Importantly, both concurrent groups are fairly similar to the <abbr class="spell">SSI</abbr>-only eligibles in terms of the percentage uninsured, suggesting that <abbr class="spell">SSI</abbr>-conditioned Medicaid access may be almost as important for the concurrent groups as for the <abbr class="spell">SSI</abbr>-only group. Finally, one of the most fascinating findings concerning health insurance coverage is that those who are not covered by either disability program display a very high overall rate of health insurance coverage (89 percent), which is a close second to the <abbr class="spell">DI</abbr>-only group (95 percent of insurance coverage).<sup><a href="#mn36" id="mt36">36</a></sup> Interestingly, these two groups contrast in terms of the proportion having health insurance coverage through their own insurance and through a family member. This provides another piece of evidence for the importance of the spouse as a source of safety net protection for some of those who are not covered by either the <abbr class="spell">SSI</abbr> or <abbr class="spell">DI</abbr> programs.</p>
|
|
<p>Those who are not covered by either <abbr class="spell">SSI</abbr> or <abbr class="spell">DI</abbr> are fairly similar to the <abbr class="spell">DI</abbr>-insured group in terms of overall access to health insurance, but display a somewhat different pattern with respect to the source of health insurance coverage; a family member—most likely a spouse—appears to be the dominant source of health insurance coverage.</p>
|
|
<h2>Conclusions and Issues for Future Research</h2>
|
|
<p>In this article we demonstrated that <abbr class="spell">SSI</abbr> provides coverage for over one-third of the working-age population against the financial risks of severe disablement. <abbr class="spell">SSI</abbr> supplements the <abbr class="spell">DI</abbr> safety net in two complementary ways: (1) it reduces the proportion of the working-age population who appear uncovered from about 23 percent to roughly 10 percent, and (2) it enhances the bundle of benefits available for a sizable group who are covered by both <abbr class="spell">DI</abbr> and <abbr class="spell">SSI</abbr> (about a quarter of the working-age population). <abbr class="spell">SSI</abbr> potentially fills a gap by providing temporary cash payments during the <span class="nobr">5-month</span> <abbr class="spell">DI</abbr> waiting period and also by supplementing <abbr class="spell">DI</abbr> benefits after the waiting period for some. In many states, optional state supplements enhance the role of <abbr class="spell">SSI</abbr> in complementing <abbr class="spell">DI</abbr>. In addition, access to Medicaid provides strong incentives to apply for <abbr class="spell">SSI</abbr>, although preexisting Medicaid eligibility and access to employer-provided health insurance dampens the incentives to apply in many cases. All in all, the role of <abbr class="spell">SSI</abbr> is substantial enough to question past practice in econometric and policy research on <abbr class="spell">DI</abbr> that essentially ignores <abbr class="spell">SSI</abbr>.</p>
|
|
<p>In this study we have focused on the potential availability of <abbr class="spell">DI</abbr>, <abbr class="spell">SSI</abbr>, and other safety net protections for the working-age population, most of which is currently not participating in either program. The "importance" or "relevance" of these safety net protections for current nonparticipants also depends on the risk of disablement that is severe enough to qualify for <abbr class="spell">SSA</abbr>'s disability programs. Although the introduction gave some information about the retrospective risk of disablement, for those who were never disabled the relevant question is the probability distribution of the risk between the present time period and the time when they would qualify for benefits based on age alone.<sup><a href="#mn37" id="mt37">37</a></sup> We can actually observe <abbr class="spell">DI</abbr> and/or <abbr class="spell">SSI</abbr> disability program entry during the first 10 years after the survey reference month, based on <abbr class="spell">SSA</abbr> administrative records. Table 7 provides program entry probabilities for persons aged <span class="nobr">18–54</span> using administrative records after the observation period of the <abbr>SIPP</abbr>. The first column shows entry probabilities for the five program coverage groups. The second column shows the overall percent that ever participated between the November 1996 reference month and October 2006. The difference is attributable to the stock of participants during the November 1996 reference month, most of which began program participation earlier. In general, the subgroups with higher cumulative entry probabilities also have higher probabilities of ever participating. Some subgroups of the working-age population have fairly high cumulative entry and participation probabilities. Those with less than high school education and three or more functional limitations stand out on both measures.</p>
|
|
<div class="table" id="table7">
|
|
<table>
|
|
<caption><span class="tableNumber">Table 7. </span>Cumulative entry and participation probabilities among individuals aged <span class="nobr">18–54</span> in November 1996, overall and for selected subgroups</caption>
|
|
<colgroup span="1" style="width:15em"></colgroup>
|
|
<colgroup span="2" style="width:15em"></colgroup>
|
|
<thead>
|
|
<tr>
|
|
<th class="stubHeading" id="c1">Variable</th>
|
|
<th id="c2">10-year cumulative entry among<br>November 1996 nonparticipants<br>(December 1996 to October 2006)</th>
|
|
<th id="c3">Ever participated between<br>November 1996 and October 2006</th>
|
|
</tr>
|
|
</thead>
|
|
<tbody>
|
|
<tr>
|
|
<td></td>
|
|
<th class="panel" colspan="2" id="r1">Percent of total <sup>a</sup></th>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub2" id="r2" headers="r1 c1">All persons</th>
|
|
<td headers="r1 r2 c2">4.0</td>
|
|
<td headers="r1 r2 c3">7.4</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub2" id="r3" headers="r1 c1"></th>
|
|
<td headers="r1 r2 r3 c2">(0.2)</td>
|
|
<td headers="r1 r2 r3 c3">(0.2)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r4" headers="r1 c1">Eligibility group</th>
|
|
<td colspan="2"></td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r5" headers="r1 r4 c1"><abbr class="spell">DI</abbr>-insured only</th>
|
|
<td headers="r1 r4 r5 c2">3.4</td>
|
|
<td headers="r1 r4 r5 c3">6.3</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub2" id="r6" headers="r1 r4 r5 c1"></th>
|
|
<td headers="r1 r4 r5 r6 c2">(0.1)</td>
|
|
<td headers="r1 r4 r5 r6 c3">(0.2)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r7" headers="r1 r4 c1"><abbr class="spell">SSI</abbr> financial-eligible only</th>
|
|
<td headers="r1 r4 r7 c2">6.0</td>
|
|
<td headers="r1 r4 r7 c3">14.3</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub2" id="r8" headers="r1 r4 r7 c1"></th>
|
|
<td headers="r1 r4 r7 r8 c2">(0.2)</td>
|
|
<td headers="r1 r4 r7 r8 c3">(0.3)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r9" headers="r1 r4 c1">Serial <abbr class="spell">SSI</abbr>/<abbr class="spell">DI</abbr></th>
|
|
<td headers="r1 r4 r9 c2">4.9</td>
|
|
<td headers="r1 r4 r9 c3">7.1</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub2" id="r10" headers="r1 r4 r9 c1"></th>
|
|
<td headers="r1 r4 r9 r10 c2">(0.2)</td>
|
|
<td headers="r1 r4 r9 r10 c3">(0.2)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r11" headers="r1 r4 c1">Joint <abbr class="spell">SSI</abbr>/<abbr class="spell">DI</abbr></th>
|
|
<td headers="r1 r4 r11 c2">4.6</td>
|
|
<td headers="r1 r4 r11 c3">11.3</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub2" id="r12" headers="r1 r4 r11 c1"></th>
|
|
<td headers="r1 r4 r11 r12 c2">(0.2)</td>
|
|
<td headers="r1 r4 r11 r12 c3">(0.2)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r13" headers="r1 r4 c1">Neither <abbr class="spell">DI</abbr> nor <abbr class="spell">SSI</abbr></th>
|
|
<td headers="r1 r4 r13 c2">2.7</td>
|
|
<td headers="r1 r4 r13 c3">3.3</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub2" id="r14" headers="r1 r4 r13 c1"></th>
|
|
<td headers="r1 r4 r13 r14 c2">(0.1)</td>
|
|
<td headers="r1 r4 r13 r14 c3">(0.1)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r15" headers="r1 c1">Education</th>
|
|
<td colspan="2"></td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r16" headers="r1 r15 c1">Less than high school</th>
|
|
<td headers="r1 r15 r16 c2">9.5</td>
|
|
<td headers="r1 r15 r16 c3">19.8</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub2" id="r17" headers="r1 r15 r16 c1"></th>
|
|
<td headers="r1 r15 r16 r17 c2">(0.2)</td>
|
|
<td headers="r1 r15 r16 r17 c3">(0.3)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r18" headers="r1 r15 c1">High school graduate</th>
|
|
<td headers="r1 r15 r18 c2">4.9</td>
|
|
<td headers="r1 r15 r18 c3">8.8</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub2" id="r19" headers="r1 r15 r18 c1"></th>
|
|
<td headers="r1 r15 r18 r19 c2">(0.2)</td>
|
|
<td headers="r1 r15 r18 r19 c3">(0.2)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r20" headers="r1 r15 c1">More than high school</th>
|
|
<td headers="r1 r15 r20 c2">2.6</td>
|
|
<td headers="r1 r15 r20 c3">4.1</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub2" id="r21" headers="r1 r15 r20 c1"></th>
|
|
<td headers="r1 r15 r20 r21 c2">(0.1)</td>
|
|
<td headers="r1 r15 r20 r21 c3">(0.2)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" id="r22" headers="r1 c1">Disability indicators <sup>b</sup></th>
|
|
<td colspan="2"></td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r23" headers="r1 r22 c1">None</th>
|
|
<td headers="r1 r22 r23 c2">2.3</td>
|
|
<td headers="r1 r22 r23 c3">2.8</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub2" id="r24" headers="r1 r22 r23 c1"></th>
|
|
<td headers="r1 r22 r23 r24 c2">(0.1)</td>
|
|
<td headers="r1 r22 r23 r24 c3">(0.1)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r25" headers="r1 r22 c1">One or two</th>
|
|
<td headers="r1 r22 r25 c2">8.7</td>
|
|
<td headers="r1 r22 r25 c3">16.7</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub2" id="r26" headers="r1 r22 r25 c1"></th>
|
|
<td headers="r1 r22 r25 r26 c2">(0.2)</td>
|
|
<td headers="r1 r22 r25 r26 c3">(0.3)</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub1" id="r27" headers="r1 r22 c1">Three or more</th>
|
|
<td headers="r1 r22 r27 c2">32.3</td>
|
|
<td headers="r1 r22 r27 c3">63.9</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub2" id="r28" headers="r1 r22 r27 c1"></th>
|
|
<td headers="r1 r22 r27 r28 c2">(0.4)</td>
|
|
<td headers="r1 r22 r27 r28 c3">(0.4)</td>
|
|
</tr>
|
|
<tr class="shaded">
|
|
<th class="stub2" id="r29" headers="r1 r22 r27 c1">Total number <sup>c</sup></th>
|
|
<td headers="r1 r22 r27 r29 c2">37,118</td>
|
|
<td headers="r1 r22 r27 r29 c3">38,540</td>
|
|
</tr>
|
|
</tbody>
|
|
<tfoot>
|
|
<tr>
|
|
<td class="firstNote" colspan="3">SOURCE: Survey of Income and Program Participation (<abbr>SIPP</abbr>) matched to Social Security Administration administrative records, November 1996.</td>
|
|
</tr>
|
|
<tr>
|
|
<td class="note" colspan="3">NOTES: <abbr class="spell">DI</abbr> = Disability Insurance; <abbr class="spell">SSI</abbr> = Supplemental Security Income.</td>
|
|
</tr>
|
|
<tr>
|
|
<td class="note" colspan="3">a. Weighted. Estimated standard errors in parentheses. The standard error estimates assume a design effect of 2.34 to account for the complex <abbr>SIPP</abbr> sample design (see Census Bureau, 2001, Table 4, <abbr title="page">p.</abbr> 22).</td>
|
|
</tr>
|
|
<tr>
|
|
<td class="note" colspan="3">b. Index is sum of the five <span class="nobr">0–1</span> variables. The value "1" is assigned to each of the following: (1) fair or poor self-reported health status; (2) presence of work-preventing or work-limiting condition, reported in two waves; (3) two or more <abbr class="spell">ADL</abbr> limitations or two or more <abbr class="spell">IADL</abbr> limitations; (4) hospitalized during previous 12 months; and (5) more than ten doctor visits during previous 12 months.</td>
|
|
</tr>
|
|
<tr>
|
|
<td class="lastNote" colspan="3">c. Unweighted number of sample observations.</td>
|
|
</tr>
|
|
</tfoot>
|
|
</table>
|
|
</div>
|
|
<p>Chart 5 shows clear patterns of variation in <span class="nobr">10-year</span> trajectories for people aged <span class="nobr">18–54</span> in November 1996, by disability program coverage groups.<sup><a href="#mn38" id="mt38">38</a></sup> The dynamic "importance" of the disability safety net varies substantially across subgroups defined by <abbr class="spell">SSI</abbr> and <abbr class="spell">DI</abbr> coverage. An important observation here is that disability program participation among those who are currently not eligible for either <abbr class="spell">DI</abbr> or <abbr class="spell">SSI</abbr>—although relatively low in comparison with the <abbr class="spell">SSI</abbr>-covered groups—is slowly moving upwards over time. This points to the importance of dynamic processes—such as asset depletion—that may affect changes in financial eligibility patterns. Chart 6 shows the cumulative entry probabilities over the <span class="nobr">10-year</span> follow-up period overall (all persons aged <span class="nobr">18–54</span>) and for two subgroups defined by educational attainment and disability status during the reference month, respectively. Similar to the overall average, the trajectory for the subgroups consisting of people with less than a high school education shows a fairly even gradual process of disability program entry. In contrast, people with three or more positive indications of disability in November 1996 have relatively high entry probabilities during the next couple of years. At the end of the <span class="nobr">10-year</span> follow-up period, we observe cumulative entry probabilities at more than twice the average (4 percent) for people with less than a high school education (9.5 percent). Almost one-third (32 percent) of people with three or more disability indicators during the reference month are observed to enter one or both disability programs during the same time period. In general, these patterns are consistent with the results of Rupp and Davies (2004) that show that the disability safety net is enormously important from a life-cycle perspective for various vulnerable groups, such as the less educated. Overall, this preview of longitudinal patterns suggests the potential for future work using a life-cycle perspective.</p>
|
|
<div class="chartCenter">
|
|
<div class="chart700" id="chart5">
|
|
<div class="title">Chart 5.<br>Cumulative disability program (<abbr class="spell">SSI</abbr> and/or <abbr class="spell">DI</abbr>) entry among nonparticipants aged <span class="nobr">18–54</span> in November 1996, by <abbr class="spell">DI</abbr>-insured and <abbr class="spell">SSI</abbr> financial-eligibility status</div>
|
|
<div class="scrollChart"><img src="v68n1p1_chart05.gif" alt="Line chart with tabular version below." width="700" height="346" /></div>
|
|
<div class="table altTable"><a class="altToggle" href="">Show as table</a>
|
|
<table>
|
|
<caption><span class="tableNumber">Table equivalent for Chart 5. </span>Cumulative disability program (<abbr class="spell">SSI</abbr> and/or <abbr class="spell">DI</abbr>) entry among nonparticipants aged <span class="nobr">18–54</span> in November 1996, by <abbr class="spell">DI</abbr>-insured and <abbr class="spell">SSI</abbr> financial-eligibility status (cumulative percent entered)</caption>
|
|
<colgroup span="1" style="width:8em"></colgroup>
|
|
<colgroup span="5" style="width:6em"></colgroup>
|
|
<thead>
|
|
<tr>
|
|
<th class="stubHeading" scope="col">Number of years from the November 1996 survey reference month</th>
|
|
<th scope="col"><abbr class="spell">DI</abbr> only</th>
|
|
<th scope="col"><abbr class="spell">SSI</abbr> only</th>
|
|
<th scope="col">Serial</th>
|
|
<th scope="col">Joint</th>
|
|
<th scope="col">Neither</th>
|
|
</tr>
|
|
</thead>
|
|
<tbody>
|
|
<tr>
|
|
<th class="stub0" scope="row">0</th>
|
|
<td>0</td>
|
|
<td>0</td>
|
|
<td>0</td>
|
|
<td>0</td>
|
|
<td>0</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">1</th>
|
|
<td>0.45</td>
|
|
<td>0.80</td>
|
|
<td>0.40</td>
|
|
<td>1.05</td>
|
|
<td>0.23</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2</th>
|
|
<td>0.83</td>
|
|
<td>1.67</td>
|
|
<td>0.83</td>
|
|
<td>1.87</td>
|
|
<td>0.60</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">3</th>
|
|
<td>1.14</td>
|
|
<td>2.80</td>
|
|
<td>1.44</td>
|
|
<td>2.72</td>
|
|
<td>0.89</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">4</th>
|
|
<td>1.54</td>
|
|
<td>3.66</td>
|
|
<td>2.19</td>
|
|
<td>3.15</td>
|
|
<td>1.20</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">5</th>
|
|
<td>1.97</td>
|
|
<td>4.51</td>
|
|
<td>2.84</td>
|
|
<td>4.21</td>
|
|
<td>1.50</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">6</th>
|
|
<td>2.41</td>
|
|
<td>5.21</td>
|
|
<td>3.53</td>
|
|
<td>4.98</td>
|
|
<td>1.80</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">7</th>
|
|
<td>2.86</td>
|
|
<td>5.96</td>
|
|
<td>4.13</td>
|
|
<td>5.14</td>
|
|
<td>2.08</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">8</th>
|
|
<td>3.20</td>
|
|
<td>6.60</td>
|
|
<td>4.76</td>
|
|
<td>5.34</td>
|
|
<td>2.49</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">9</th>
|
|
<td>3.40</td>
|
|
<td>7.15</td>
|
|
<td>5.09</td>
|
|
<td>5.76</td>
|
|
<td>2.80</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">10</th>
|
|
<td>3.50</td>
|
|
<td>7.54</td>
|
|
<td>5.39</td>
|
|
<td>6.14</td>
|
|
<td>2.92</td>
|
|
</tr>
|
|
</tbody>
|
|
<tfoot>
|
|
<tr>
|
|
<td class="noNotes" colspan="6"> </td>
|
|
</tr>
|
|
</tfoot>
|
|
</table>
|
|
</div>
|
|
<div class="firstNote">SOURCE: Survey of Income and Program Participation matched to Social Security Administration administrative records, November 1996.</div>
|
|
<div class="lastNote">NOTE: <abbr class="spell">SSI</abbr> = Supplemental Security Income; <abbr class="spell">DI</abbr> = Disability Insurance.</div>
|
|
</div>
|
|
</div>
|
|
<div class="chartCenter">
|
|
<div class="chart700" id="chart6">
|
|
<div class="title">Chart 6.<br>Cumulative disability program (SSI and/or DI) entry among nonparticipants aged 18–54 in November 1996, overall and for selected subgroups</div>
|
|
<div class="scrollChart"><img src="v68n1p1_chart06.gif" alt="Line chart with tabular version below." width="700" height="336" /></div>
|
|
<div class="table altTable"><a class="altToggle" href="">Show as table</a>
|
|
<table>
|
|
<caption><span class="tableNumber">Table equivalent for Chart 6. </span>Cumulative disability program (<abbr class="spell">SSI</abbr> and/or <abbr class="spell">DI</abbr>) entry among nonparticipants aged <span class="nobr">18–54</span> in November 1996, overall and for selected subgroups (cumulative percent entered)</caption>
|
|
<colgroup span="1" style="width:8em"></colgroup>
|
|
<colgroup span="3" style="width:6em"></colgroup>
|
|
<thead>
|
|
<tr>
|
|
<th class="stubHeading" scope="col">Number of years from the November 1996 survey reference month</th>
|
|
<th scope="col">All</th>
|
|
<th scope="col">Less than high school education</th>
|
|
<th scope="col">Three or more disability indicators</th>
|
|
</tr>
|
|
</thead>
|
|
<tbody>
|
|
<tr>
|
|
<th class="stub0" scope="row">0</th>
|
|
<td>0</td>
|
|
<td>0</td>
|
|
<td>0</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">1</th>
|
|
<td>0.35</td>
|
|
<td>0.75</td>
|
|
<td>8.36</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">2</th>
|
|
<td>0.70</td>
|
|
<td>1.84</td>
|
|
<td>14.16</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">3</th>
|
|
<td>1.11</td>
|
|
<td>2.87</td>
|
|
<td>18.54</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">4</th>
|
|
<td>1.58</td>
|
|
<td>4.19</td>
|
|
<td>21.72</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">5</th>
|
|
<td>2.08</td>
|
|
<td>5.40</td>
|
|
<td>24.61</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">6</th>
|
|
<td>2.60</td>
|
|
<td>6.25</td>
|
|
<td>26.78</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">7</th>
|
|
<td>3.07</td>
|
|
<td>7.30</td>
|
|
<td>27.91</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">8</th>
|
|
<td>3.51</td>
|
|
<td>8.17</td>
|
|
<td>29.95</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">9</th>
|
|
<td>3.89</td>
|
|
<td>8.90</td>
|
|
<td>31.79</td>
|
|
</tr>
|
|
<tr>
|
|
<th class="stub0" scope="row">10</th>
|
|
<td>4.02</td>
|
|
<td>9.47</td>
|
|
<td>32.34</td>
|
|
</tr>
|
|
</tbody>
|
|
<tfoot>
|
|
<tr>
|
|
<td class="noNotes" colspan="4"> </td>
|
|
</tr>
|
|
</tfoot>
|
|
</table>
|
|
</div>
|
|
<div class="firstNote">SOURCE: Survey of Income and Program Participation matched to Social Security Administration administrative records, November 1996.</div>
|
|
<div class="lastNote">NOTE: <abbr class="spell">SSI</abbr> = Supplemental Security Income; <abbr class="spell">DI</abbr> = Disability Insurance.</div>
|
|
</div>
|
|
</div>
|
|
<p>Several specific areas of additional research are called for to enhance our understanding of the role of <abbr class="spell">SSI</abbr> in supplementing the <abbr class="spell">DI</abbr> safety net. Some important yet unexplored issues are as follows:</p>
|
|
<ul>
|
|
<li><i>The effect of <abbr class="spell">DI</abbr> and <abbr class="spell">SSI</abbr> on income change associated with potential disability program entry.</i> This is clearly another important dimension of the potential value of these safety net protections and should also help in understanding the financial incentives at work. The traditional concept of the <abbr class="spell">DI</abbr> wage replacement rate may be misleading because it ignores <abbr class="spell">SSI</abbr>/<abbr class="spell">DI</abbr> dynamic program interactions, is not applicable to people without labor force attachment, and ignores the broader family context. The broader, and more relevant, concept is net family income change attributable to qualifying disablement. Unlike the wage replacement rate, the net family income change concept can be applied both to persons with substantial labor force attachment and to others with little or no prior work experience. Finally, the wage replacement rate is not an indicator of distributional outcomes, yet net family income change is.</li>
|
|
<li><i>Long-term trends in disability coverage.</i> What changes can be expected in disability coverage in the future? What are the major factors underlying long-term trends in <abbr class="spell">DI</abbr> and <abbr class="spell">SSI</abbr> disability coverage? Relevant factors may include increased female labor force participation, changes in family structures, fertility, trends in real wages, and income distribution. Program design features, such as the wage indexing of initial <abbr class="spell">DI</abbr> benefits in contrast to the inflation-adjusted <abbr class="spell">SSI</abbr> income guarantee and the recent shift to wage indexing of the <abbr class="spell">SGA</abbr> threshold, may also affect future trends.<sup><a href="#mn39" id="mt39">39</a></sup></li>
|
|
<li><i>Factors affecting disability program participation.</i> What are the differences in the rate of program participation among groups with varying patterns of <abbr class="spell">SSI</abbr> and <abbr class="spell">DI</abbr> coverage? Can such differences be attributable to differences in the demographic and disability/health status variables? Is there evidence to suggest that serial or concurrent coverage increases the propensity to participate? What are the implications of differences between the working-aged and the elderly for <abbr class="spell">SSI</abbr> simulation modeling?</li>
|
|
<li><i>The effect of <abbr class="spell">DI</abbr> and <abbr class="spell">SSI</abbr> coverage and potential benefit bundles on disability program entry that may result from a severe health/disability shock.</i> What are the longitudinal patterns of disability program entry? What are the effects of disability program entry on the financial well-being of subgroups with differential access to various programs, pension assets, and housing equity?</li>
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|
<li><i>Longitudinal patterns of disability program participation and public health insurance coverage after first entitlement to benefits.</i> What proportion of new awardees has access to Medicaid before <abbr class="spell">SSI</abbr> or <abbr class="spell">DI</abbr> award? What is the role of Medicaid during the <span class="nobr">24-month</span> Medicare waiting period and beyond? What proportion of <abbr class="spell">DI</abbr>-only awardees eventually qualifies for <abbr class="spell">SSI</abbr> and Medicaid? What is the effect of the timing of disability applications and award decisions on the pattern of these safety net protections?</li>
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|
</ul>
|
|
<p>These and other topics can be addressed using a variety of data sources, such as the <abbr>SIPP</abbr>, the Health and Retirement Study, and linked Social Security, <abbr class="spell">SSI</abbr>, Medicare, and Medicaid records. Some issues can be fruitfully addressed using cross-sectional data, and others call for longitudinal designs.</p>
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<div id="notes">
|
|
<h2>Notes</h2>
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|
<p> <a href="#mt1" id="mn1">1</a>. In this chart, participation is restricted to participation in <abbr class="spell">DI</abbr> or in the <abbr class="spell">SSI</abbr> program as a disabled or blind working-age adult.</p>
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<p> <a href="#mt2" id="mn2">2</a>. <abbr class="spell">DI</abbr>-insured status does not require disablement. However, <abbr class="spell">DI</abbr>-insured status is necessary for a person to qualify for <abbr class="spell">DI</abbr> award. Once an applicant meets this test and is awarded benefits, we consider them to continue to have <abbr class="spell">DI</abbr> coverage.</p>
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<p> <a href="#mt3" id="mn3">3</a>. The <abbr class="spell">FBR</abbr> was $623 for a qualifying individual and $934 for a qualifying couple for calendar year 2007 and is subject to annual cost-of-living adjustments (<abbr>COLA</abbr>s). The corresponding values for 2008 are $637 and $956, respectively. In September 2007, the average <abbr class="spell">SSI</abbr> payment to recipients aged <span class="nobr">18–64</span> was $482.40. In comparison, the average <abbr class="spell">DI</abbr> benefit to disabled workers in September 2007 was $979.70.</p>
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<p> <a href="#mt4" id="mn4">4</a>. The <abbr class="spell">SGA</abbr> is operationalized in terms of qualifying earnings at certain monthly levels. In 2007, for nonblind individuals, monthly earnings above $900 is treated as prima facie evidence of the applicant's ability to engage in <abbr class="spell">SGA</abbr>. The 2008 <abbr class="spell">SGA</abbr> is $940. The <abbr class="spell">SGA</abbr> determination is based on pretax earnings after deductions for impairment-related work expenses (if any) and considers some other factors as well. Since January 1, 2001, the <abbr class="spell">SGA</abbr> thresholds are subject to annual indexing to account for growth in average wages. The 2007 <abbr class="spell">SGA</abbr> is about 1 percent above the monthly earnings of a full-time worker (assuming 2,080 hours of work per year) at the minimum hourly wage of $5.25 that has been in effect during recent years. In May 2007 the President signed a bill to increase the minimum wage in three steps. During the summer of 2007 the rate increases to $5.85 per hour: the 2007 annualized <abbr class="spell">SGA</abbr> amounts to only 89 percent of the annual wages of a full-time minimum wage earner at $5.85 per hour. (Authors' calculations based on <a href="https://www.dol.gov/agencies/whd">http://www.dol.gov/esa/whd/</a>, accessed on June 13, 2007.) The shift to a wage-indexed <abbr class="spell">SGA</abbr> in 2001 and the 2007 minimum wage legislation may affect the generalizability of the point estimates of disability benefit coverage we present later in the article, all based on 1996 data.</p>
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<p> <a href="#mt5" id="mn5">5</a>. There is a general income exclusion rule allowing for the disregard of up to $20 of income each month from any source.</p>
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<p> <a href="#mt6" id="mn6">6</a>. In fact <abbr class="spell">SSI</abbr> eligibility may lead to retroactive Medicaid eligibility for up to 3 months in some cases. States may establish Medicaid eligibility for the recipient as early as the first day of the third month preceding the month of application for <abbr class="spell">SSI</abbr> payments. (For more information, see <abbr class="spell">SSA</abbr> Program Operations Manual System (<abbr>POMS</abbr>) <abbr class="spell">SI</abbr> 01730.010).</p>
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<p> <a href="#mt7" id="mn7">7</a>. For further detail, see <abbr class="spell">SSA</abbr> <abbr class="spell">POMS</abbr> <abbr class="spell">DI</abbr> 25501.051 and <abbr class="spell">SSA</abbr> <abbr class="spell">POMS</abbr> <abbr class="spell">SI</abbr> 00601.009.</p>
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<p> <a href="#mt8" id="mn8">8</a>. For more information, see the <i>Annual Statistical Supplement to the Social Security Bulletin, 2006</i>, Tables 5.D3 and 7.A9.</p>
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<p> <a href="#mt9" id="mn9">9</a>. Also known as the Master File of Social Security Number Holders and Applications.</p>
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<p><a href="#mt10" id="mn10">10</a>. The estimated standard errors of the proportions reported in this article were derived using the formula:<br> s.e. = √[p*(1-p)/n] * √DEFF,<br>where s.e. = estimated standard error, p = estimated proportion, n = unweighted number of observations forming the base of the proportion, and DEFF = estimated design effect. Using information from the 1996 <abbr>SIPP</abbr> Source and Accuracy Statement (Census Bureau, 2001, Table 4, 22), we assume a constant DEFF = 2.34 to account for the complex <abbr>SIPP</abbr> sample design.</p>
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<p><a href="#mt11" id="mn11">11</a>. In the current application of the <abbr class="spell">FEM</abbr> we ignore in-kind support and maintenance provisions that may affect financial eligibility.</p>
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<p><a href="#mt12" id="mn12">12</a>. In our simulations we consider only the <abbr class="spell">SSI</abbr> federal cash benefit guarantee. Note that the <abbr class="spell">SSI</abbr> program also includes state supplementary benefits. Although state supplements are relevant to assess the expected total cash value of <abbr class="spell">SSI</abbr> benefits, they have a relatively limited effect on the determination of eligibility to receive <abbr class="spell">SSI</abbr>.</p>
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<p><a href="#mt13" id="mn13">13</a>. Our measure is "conservative" because disability shocks may result in an earnings capacity reduced to zero or close to zero. Some may argue that the measure is not conservative in that people may have in-program earnings that are above <abbr class="spell">SGA</abbr> but do not lose benefit eligibility status as a result. However, the bulk of current beneficiaries have zero or below-<abbr class="spell">SGA</abbr> earnings, and only a small fraction has above-<abbr class="spell">SGA</abbr> earnings. More importantly, the key to the role of own earnings in estimating <abbr class="spell">SSI</abbr> coverage is this: For a person to transition from "nondisabled" to "disabled" status, it is necessary for earnings to be below or to drop below the <abbr class="spell">SGA</abbr> level. Before 2001, <abbr class="spell">SGA</abbr> had a "high" and "low" value. Persons with earnings below the "low" value are presumed to meet the <abbr class="spell">SGA</abbr> test. Those with earnings between the "high" and "low" values are subject to additional considerations, and persons with earnings above the "high" value are presumed not to be disabled. In 1996 the high and low <abbr class="spell">SGA</abbr> values were $500 and $300, respectively. We use the $500 value in our estimates, which results in somewhat more conservative estimates of the number of persons meeting the <abbr class="spell">SSI</abbr> financial eligibility test and the expected <abbr class="spell">SSI</abbr> benefits than the $300 value would render.</p>
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<p><a href="#mt14" id="mn14">14</a>. If one allows for other changes over time, additional complexities arise. For example, some <abbr class="spell">SSI</abbr>-only awardees may gain <abbr class="spell">DI</abbr>-insured status because of work experience while in <abbr class="spell">SSI</abbr> benefit status. Likewise, <abbr class="spell">DI</abbr>-only awardees may become financially eligible for <abbr class="spell">SSI</abbr> as a result of asset spend down, changes in earned and unearned income, or marital status.</p>
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<p><a href="#mt15" id="mn15">15</a>. We also ignore annual cost of living adjustments here to simplify the presentation.</p>
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<p><a href="#mt16" id="mn16">16</a>. If the person has income amounting to $20 or more from other sources, our simplifying assumption that ignores the potential excludability of up to $20 of <abbr class="spell">DI</abbr> benefit makes no difference. In contrast, if the person has no income from other sources, the disposition as "serial" or "joint" beneficiary may be slightly different, and the combined monthly benefit after the <span class="nobr">5-month</span> waiting period will be up to $20 higher than the <abbr class="spell">SSI</abbr>-only benefit during the <span class="nobr">5-month</span> waiting period.</p>
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<p><a href="#mt17" id="mn17">17</a>. Groups 2 and 3 combined are referred to as "concurrent eligibles."</p>
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<p><a href="#mt18" id="mn18">18</a>. The second column of Table 1 presents the distribution using the unadjusted <abbr class="spell">SSI</abbr> financial eligibility measure (which is based on observed current income) to look at the sensitivity of the point estimates to the shift to our preferred eligibility measure (which accounts for the earnings loss that is a necessary condition of categorical eligibility) that is presented in the first column. Overall, the data show that the unadjusted measure substantially underestimates the proportion of the working-age population covered by <abbr class="spell">SSI</abbr> (20 percent versus the preferred estimate of 36 percent, and the difference is statistically significant). A salient detailed difference is the increase in the concurrent eligibles group and the corresponding decrease in the group that is only insured for <abbr class="spell">DI</abbr> as we move towards our preferred coverage estimate. Approximately one-fifth of those classified as <abbr class="spell">DI</abbr>-only under the unadjusted measure become concurrent eligibles under our preferred measure. Another important shift here is from the "Neither" group to the <abbr class="spell">SSI</abbr>-only group for similar reasons. Almost one-fourth of those who appear ineligible for both programs under the unadjusted measure become <abbr class="spell">SSI</abbr>-only eligible under our preferred measure. All of the differences between the adjusted and unadjusted percentages of the four subgroups are statistically significant.</p>
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<p><a href="#mt19" id="mn19">19</a>. This is comparable with the estimated 78 percent of the Social Security area population aged <span class="nobr">20–64</span> that was <abbr class="spell">DI</abbr>-insured in 1995. (For more information, see Social Security Administration (2005), available at <a href="/policy/docs/chartbooks/fast_facts/2005/fast_facts05.html">http://www.ssa.gov/policy/docs/chartbooks/fast_facts/2005/fast_facts05.html</a>.) One reason for our estimate being somewhat lower is that we estimate the proportion for the population aged <span class="nobr">18–64</span> representing a larger denominator without a tangible increase in the numerator. Adjusting for this difference in definition should increase the <abbr>SIPP</abbr> estimate to around 79 percent, which is slightly higher than <abbr class="spell">SSA</abbr>'s estimate of 78 percent above, possibly because the <abbr>SIPP</abbr> sample frame excludes the institutional population.</p>
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<p><a href="#mt20" id="mn20">20</a>. Authors' calculation: 23.5 / 36.1 = 65 percent.</p>
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|
<p><a href="#mt21" id="mn21">21</a>. Author's calculation: 12.6 / (100-77) = 55 percent.</p>
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|
<p><a href="#mt22" id="mn22">22</a>. We derived corresponding estimates for 1991 from the 1990 <abbr>SIPP</abbr> panel (wave 4, month 4 reference month). Overall the patterns were similar. We note that the proportion of <abbr class="spell">DI</abbr>-insured only (46 percent) and <abbr class="spell">SSI</abbr>-eligible only (10.8 percent) were relatively low in 1991. In contrast, a relatively high portion (30.3 percent) was classified as concurrent eligibles.</p>
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<p><a href="#mt23" id="mn23">23</a>. Note that some of these people might transition to <abbr class="spell">DI</abbr> and/or <abbr class="spell">SSI</abbr> coverage at some point subsequent to the survey reference month.</p>
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<p><a href="#mt24" id="mn24">24</a>. Rupp and Davies (2004) provide comparable information for both participants and nonparticipants.</p>
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|
<p><a href="#mt25" id="mn25">25</a>. Mitchell and Phillips (2001) estimate probit models of <abbr class="spell">DI</abbr>-insured status and find that those who are in poor health are less likely to be <abbr class="spell">DI</abbr>-insured. Our findings here suggest that once <abbr class="spell">SSI</abbr> eligibility is explicitly accounted for, those who are not covered by either program are still more likely to be in poor health than <abbr class="spell">DI</abbr>-only and concurrent eligibles. Thus, while a big chunk of the seemingly uncovered population in the Mitchell-Phillips analysis is actually covered by <abbr class="spell">SSI</abbr>, their qualitative concern seems robust.</p>
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<p><a href="#mt26" id="mn26">26</a>. Of course, the poverty rate can be recalculated using <abbr class="spell">SGA</abbr>-constrained own earnings and other assumptions about changes in family income such as changes attributable to disability program participation. This kind of exercise might be useful in some future study of net income replacement associated with disablement. However, in the current study we are focusing on the current characteristics of groups with different patterns of disability coverage. Therefore, the unadjusted poverty rate is the appropriate measure in this context.</p>
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|
<p><a href="#mt27" id="mn27">27</a>. Actually, the <abbr class="spell">DI</abbr>-only group has an estimated proportion that is 2 percentage-points lower than for the other group. The difference is statistically significant, although the magnitude may not be meaningful.</p>
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|
<p><a href="#mt28" id="mn28">28</a>. This may suggest some incentive for asset spend down. However, for those who are both income and asset ineligible this incentive is insufficient for gaining <abbr class="spell">SSI</abbr> eligibility. Also, many may simply spend down assets to substitute lost income associated with a disability shock or other factors, without engaging in strategic behavior. Both of these factors limit the potential scope of the moral hazard argument.</p>
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|
<p><a href="#mt29" id="mn29">29</a>. The disability determination process is widely regarded as much longer and more cumbersome than the application process for many other programs, including <abbr>TANF</abbr> and Food Stamp.</p>
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|
<p><a href="#mt30" id="mn30">30</a>. <abbr class="spell">DI</abbr> application may be delayed as a result of access to these alternatives; as discussed earlier this may result in forfeiting potential <abbr class="spell">SSI</abbr> payments. <abbr class="spell">DI</abbr> benefit eligibility would be affected only if the onset of a qualifying disability occurred 13 months or more before <abbr class="spell">DI</abbr> application.</p>
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|
<p><a href="#mt31" id="mn31">31</a>. Although our primary interest here is coverage, other studies looking at the interaction among the various programs use different—and complementary—perspectives. The differences need to be considered in interpreting empirical results. For example, Burkhauser and Wittenburg (1996) look at simultaneous participation in several programs to gauge program interactions. Honeycutt (2004) also looks at participation, but uses a longitudinal design; his interest is in the antecedents of <abbr class="spell">DI</abbr> entry. Both of these perspectives are useful to describe realized (observed) participation patterns, but appear limited in terms of understanding the participation choices themselves. Information on coverage and other program parameters are relevant for describing the opportunity set of potential participants and the resulting decisions.</p>
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|
<p><a href="#mt32" id="mn32">32</a>. Note that <abbr class="spell">DI</abbr>-insured status is conditioned on relatively stable prior employment experience. Conversely, <abbr class="spell">SSI</abbr>-only eligibility implies the lack of it. In addition, the <abbr class="spell">SSI</abbr> income test screens out people with substantial earnings.</p>
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|
<p><a href="#mt33" id="mn33">33</a>. In some cases, people may lose such eligibility before actual disablement because of factors such as loss of <abbr>TANF</abbr> as a result of children passing age 18.</p>
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|
<p><a href="#mt34" id="mn34">34</a>. In Chart 4 "Own health insurance" is the sum of "health insurance in own name, private" and "health insurance in own name, employer." The statistics may be a slight overestimate, because some people may have both. Note also that because some persons may have health insurance from several sources and others from none at all, the percentages in this chart do not necessarily add up to 100 percent.</p>
|
|
<p><a href="#mt35" id="mn35">35</a>. Both numbers reflect authors' calculation; data not shown.</p>
|
|
<p><a href="#mt36" id="mn36">36</a>. See Table 6.</p>
|
|
<p><a href="#mt37" id="mn37">37</a>. For our analytical sample, the full retirement age (<abbr class="spell">FRA</abbr>) and the <abbr class="spell">SSI</abbr> threshold of categorical eligibility as aged were identical—age 65. The two thresholds have been divorced more recently as a result of the gradual increase of the <abbr class="spell">FRA</abbr> to 67. Another complicating factor is that people are eligible for early Social Security retirement benefits—with an actuarial reduction—at age 62. Thus the relevant life-cycle horizon definitely reaches age 62 for <abbr class="spell">DI</abbr> and age 65 for<abbr class="spell"> </abbr>SSI, with the period between 62 years of age and the <abbr class="spell">FRA</abbr> characterized by the availability of both <abbr class="spell">DI</abbr> and Social Security early retirement benefits.</p>
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|
<p><a href="#mt38" id="mn38">38</a>. Our interest is in disability program participation before reaching age 65. Persons aged 55 during the survey reference month would reach their 65th birthday by the end of the <span class="nobr">10-year</span> follow-up period, therefore we limited data in Charts 5 and 6 to persons aged <span class="nobr">18–54</span> during the reference month.</p>
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<p><a href="#mt39" id="mn39">39</a>. Under current law initial Social Security benefits are wage-indexed, but other indexing schemes have also been considered in recent discussions of Social Security reform options. The <abbr class="spell">SGA</abbr> threshold has been wage-indexed since January 2001; previously it was subject to ad hoc increases only. The <abbr class="spell">SSI</abbr> federal benefit rate is annually adjusted for changes in the consumer price index using the same formula that drives annual cost-of-living adjustments for Social Security benefits.</p>
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</div>
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<div id="references">
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<h2>References</h2>
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<p>Bound, John, and Richard V. Burkhauser. 1999. The economic analysis of transfer programs targeted on people with disabilities. In <i>Handbook of labor economics</i>, Volume 2C, Orley C. Ashenfelter and David Card, <abbr title="editors">eds</abbr>. Amsterdam: North Holland.</p>
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<p>Burkhauser, Richard V., and David C. Wittenburg. 1996. How current disability transfer policies discourage work: Analysis from the 1990 <abbr>SIPP</abbr>. <i>Journal of Vocational Rehabilitation</i> 7(1): <span class="nobr">9–27</span>.</p>
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<p>Census Bureau. 2001. Source and accuracy statement for 1996 panel wave 1–wave 12 public-use files from the Survey of Income and Program Participation. <a href="https://data.nber.org/sipp/1996/s&a96_040501.pdf">http://www.nber.org/sipp/1996/s&a96_040501.pdf</a>.</p>
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<p>Coile, Courtney C. 2004. Health shocks and couples' labor supply decisions. <abbr class="spell">NBER</abbr> Working Paper <abbr title="Number">No.</abbr> 10810. Cambridge, <abbr title="Massachusetts">MA</abbr>: National Bureau of Economic Research.</p>
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<p>Davies, Paul S. 2002. <abbr class="spell">SSI</abbr> eligibility and participation among the oldest old: Evidence from the AHEAD.<i>Social Security Bulletin</i> 64(3): <span class="nobr">38–63</span>.</p>
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<p>Davies, Paul S., Minh Huynh, Chad Newcomb, Paul O'Leary, Kalman Rupp, and Jim Sears. 2002. Modeling <abbr class="spell">SSI</abbr> financial eligibility and simulating the effect of policy options. <i>Social Security Bulletin</i> 64(2): <span class="nobr">16–45</span>.</p>
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<p>Davies, Paul S., Kalman Rupp, and Alexander Strand. 2004. The potential of the <abbr class="spell">SSI</abbr> program to reduce poverty among the elderly. <i>Journal of Aging and Social Policy</i> 16(1): <span class="nobr">21–42</span>.</p>
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<p>Foote, Sandra M., and Christopher Hogan. 2001. Disability profile and health care costs of Medicare beneficiaries under age sixty-five. <i>Health Affairs</i> 20(6): <span class="nobr">242–253</span>.</p>
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<p>Gruber, Jonathan and Jeffrey Kubik. 2002. Health Insurance coverage and the Disability Insurance application decision. <abbr class="spell">NBER</abbr> Working Paper <abbr title="Number">No.</abbr> 9148. Cambridge, <abbr title="Massachusetts">MA</abbr>: National Bureau of Economic Research.</p>
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<p>Honeycutt, Todd C. 2004. Program and benefit paths to the Social Security Disability Insurance program. <i>Journal of Vocational Rehabilitation</i> 21(2): <span class="nobr">83–94</span>.</p>
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<p>McGarry, Kathleen. 1996. Factors determining participation of the elderly in Supplemental Security Income. <i>Journal of Human Resources</i> 31(2): <span class="nobr">331–358</span>.</p>
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<p><span class="nobr">———</span>. 2002. Guaranteed income: <abbr class="spell">SSI</abbr> and the well-being of the elderly poor. In <i>Distributional aspects of Social Security and Social Security reform</i>, M. Feldstein and J. B. Liebman, <abbr title="editors">eds.</abbr>, <span class="nobr">49–78</span>. Chicago, <abbr title="Illinois">IL</abbr>: The University of Chicago Press.</p>
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<p>Meyer, Bruce D., and Wallace K. C. Mok. 2006. Disability, earnings, income and consumption. Harris School Working Paper Series <span class="nobr">06–10</span>, Chicago, <abbr title="Illinois">IL</abbr>: University of Chicago, Irving B. Harris Graduate School of Public Policy Studies (December 4), 93.</p>
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<p>Meyer, Bruce D., and James X. Sullivan. 2006. Underreporting of transfers in household surveys: Comparisons of administrative aggregates. Working Paper. Chicago, <abbr title="Illinois">IL</abbr>: University of Chicago, Irving B. Harris Graduate School of Public Policy Studies (May 3).</p>
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<p>Mitchell, Olivia S., and John W. R. Phillips. 2000. Retirement responses to early Social Security benefit reductions. <abbr class="spell">NBER</abbr> Working Paper <abbr title="Number">No.</abbr> 7963. Cambridge, <abbr title="Massachusetts">MA</abbr>: National Bureau of Economic Research.</p>
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<p><span class="nobr">———</span>. 2001. Eligibility for Social Security Disability Insurance. Pension Research Council Working Paper <abbr title="Number">No.</abbr> <span class="nobr">2001–11</span>, Philadelphia, <abbr title="Pennsylvania">PA</abbr>: Wharton School of the University of Pennsylvania.</p>
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<p>National Academy of Social Insurance. 2006. Workers' compensation: Benefits, coverage and costs, 2004. Washington, DC: National Academy of Social Insurance.</p>
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<p>Riley, Gerald F. 2006. Health insurance and access to care among Social Security disability beneficiaries during the Medicare waiting period. <i>Inquiry</i> 43(Fall): <span class="nobr">222–230</span>.</p>
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<p>Riley, Gerald F., James D. Lubitz, and Nancy Zhang. 2003. Patterns of health care and disability for Medicare beneficiaries under 65. <i>Inquiry</i> 40(Spring): <span class="nobr">71–83</span>.</p>
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<p>Rupp, Kalman, and Charles Scott. 1998. Determinants of duration on the disability rolls and program trends. In <i>Growth in disability benefits: Explanations and policy implications</i>, K. Rupp and D. Stapleton, <abbr title="editors">eds</abbr>. <span class="nobr">139–173</span>. Kalamazoo, <abbr title="Michigan">MI</abbr>: W. E. Upjohn Institute for Employment Research.</p>
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<p>Rupp, Kalman, Alexander Strand, and Paul S. Davies. 2003. Poverty among elderly women: Assessing <abbr class="spell">SSI</abbr> options to strengthen Social Security reform. <i>Journals of Gerontology: Social Sciences</i> 58B (5): <span class="nobr">S359–S368</span>.</p>
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<p>Rupp, Kalman, and Paul S. Davies. 2004. A long-term view of health status, disabilities, mortality, and participation in the <abbr class="spell">DI</abbr> and <abbr class="spell">SSI</abbr> disability programs. In <i>Research in labor economics: Accounting for worker well-being</i>, Volume 23, Solomon Polachek, <abbr title="editor">ed</abbr>. Amsterdam: Elsevier, <abbr class="spell">JAI</abbr> Press.</p>
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<p>Social Security Administration. 2005. <i>Fast facts and figures about Social Security, 2005</i>. Washington, DC: Office of Policy, Office of Research, Evaluation, and Statistics.</p>
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<p><span class="nobr">———</span>. 2007a. <i>Annual Statistical Supplement to the Social Security Bulletin, 2006</i>. Washington, DC: Office of Policy, Office of Research, Evaluation, and Statistics.</p>
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<p><span class="nobr">———</span>. 2007b. <i>Fiscal year 2008 justification of estimates for appropriations committees</i>. Washington, DC. http://www.socialsecurity.gov/budget/2008cjapp.pdf.</p>
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<p><span class="nobr">———</span>. 2008. <i>Program operations manual system (<abbr>POMS</abbr>)</i> <abbr class="spell">SI</abbr> 01730.010, <abbr class="spell">DI</abbr> 25501.051, and <abbr class="spell">SI</abbr> 00601.009.</p>
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<p>Sohota, Gian S. 1978. Theories of personal income distribution: A survey. <i>Journal of Economic Literature</i> 16(1): <span class="nobr">1–55</span>.</p>
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